Your providers submit requests to us online or over the phone.
Our automated platform reviews requests in real time.
Requests meeting clinical criteria are immediately approved. Our clinical reviewers, including board-certified surgeons and nurses, are available to consult with your providers about any requests that don’t meet our clinical criteria and/or health plan medical policy.
We redirect surgical procedures to high-value sites of care when clinically appropriate.
Review request data is shared with your system(s) for claims, care management, and/or reporting purposes.