The business world is full of acronyms. Terms such as ROI (return on investment), CMS (content management system), CPL (cost per lead), KPI (key performance indicator) and API (application program interface) are discussed by many working professionals on a regular basis. Two well-known acronyms for health plans and payers are IME, otherwise known as independent […]
Tag: utilization management
Clear communication is essential in many facets of life. Whether it’s a teacher telling students about classroom rules or a physician explaining a diagnosis to a patient, providing easy-to-understand direction is important. This need for clear and open communication is evident in the healthcare industry because it can make the difference in outcomes, patient safety, […]
In the healthcare industry, missing a new regulation or alternative treatment could cost you more than money or time. In order to stay informed, we’ve rounded up the most recent updates: New Non-Opioid Treatments For Opiate Withdrawal In response to the national opioid crisis, the FDA has recently approved two new treatments to mitigate […]
In a study conducted by The Journal of Healthcare Information Management, it was discovered that 86 percent of mistakes made in the healthcare industry are administrative. These small administrative mistakes, whether it’s the misspelling of a name or a misrecorded number, can have a major effect when they go unnoticed. With the fast-paced and, at […]
Did you know that more than 10,000 baby boomers reach retirement age every single day? It’s a staggering figure, but it makes sense considering the overall size of their generation. Born between 1946 and 1964, they are one of the largest population cohorts in U.S. history, with approximately 74 million members alive through 2016. Their […]
The gold standard for evidence for EBM – randomized controlled trials (RCTs) – only emerged in the 20th century.
Wondering where an IRO fits into the external review process? How about whether an RN versus an MD can approve or deny a case? Check out our infographic on The Life of a Group Health Case to learn about physician-level reviews and the role of an IRO in Group Health plans!
2017 is here! Last year was a phenomenal year for Advanced Medical Reviews, so let’s take a moment to look back on 2016 and all that we accomplished. We hope you enjoy our very first Video Blog!
When people learn they have medical conditions, they naturally leap to the next step: treatment. But choosing the right treatment is not always a black-and-white process, particularly for men with prostate cancer. Each person’s injury or disease is affected by his or her gender, age, lifestyle and other medical needs. There is rarely only one […]
Individuals battling sarcoma will undergo countless tests, procedures and treatments over the course of months or years. The goal of Utilization Review is for patients to receive the best care possible. Insurers use an evidence-based approach during Utilization Review to make sure patients do not receive duplicate or un-proven procedures. Utilization Review During Sarcoma […]