MedCost’s Health Management has performed aggressive inpatient utilization management nationwide for 20 years. Our experienced clinical staff use established professional guidelines to determine medical necessity. The objective of this program is to balance patient care quality, safety, and cost-effectiveness.

A registered nurse performs a preadmission review — a review of a planned hospital admission, to ensure that hospitalization occurs only when medically necessary and in the most cost-effective setting. After a patient is admitted, concurrent monitoring determines the medical necessity of each continued day of hospitalization.

Inpatient Utilization Management includes pre-admission review, concurrent review, retrospective review, discharge planning, and referral to case management as appropriate.

The goal of Health Management Inpatient Review is to prevent overuse of hospital care while giving your insureds’ health top priority. The program is simple to use. The result for clients:

• Fewer hospital admissions and days per 1000
• Significant cost savings
• Increased level of patient satisfaction