Case Management and Utilization Review
AHDI's Medical Management services include Utilization Review and Case Management. Utilization Review includes precertification done for inpatient stays, as well as outpatient services, if required by the plan. Case Management identifies patients with complex or catastrophic illnesses, patients with potential high-cost treatment, and continuous inpatient facility stays of longer than seven days. A diagnosis list is used as a reference to identify potential candidates for Case Management.