Innovating a new model of utilization review

The old paradigms of UR are no longer enough

Disruptive events, the changing commercial payer denial landscape and the rise of value-based reimbursement (VBR) have made UR more difficult. Fortunately, new processes and technologies that apply artificial intelligence can simplify UR efforts. In turn, case managers can shift their attention to improving the quality measures upon which VBR depends.

This white paper discusses how hospitals can accomplish this shift and explains the key features AI requires to deliver on this promise.