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Multiple contracts in 42 states for provision of independent/external peer review
services. |
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Healthcare utilization
and quality management experience dating back to 1972. |
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URAC accredited in Health
Utilization Management from 1999 to 2009, and as an Independent
Review Organization since 2009. |
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Completed
nearly 2 million
utilization and quality assurance reviews in the public healthcare
marketplace. |
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Named
one of the top 10 largest utilization management providers in
the country by Business Insurance magazine. |
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IRO contractor with
Illinois Healthcare and Family Services |
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IRO contractor with
Missouri Department of Insurance |
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Medicare Quality
Improvement Organization in Nebraska through subsidiary CIMRO
of Nebraska. |
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Provide case management
services to Missouri Medicaid recipients. |
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Provide
quality oversight expertise to Critical Access Hospitals to
assist in meeting Federal Conditions of Participation. |
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Medicaid Peer Review Organization
(PRO) and Quality Assurance Organization (QAO)/External Quality
Review Organization for the Illinois Department of Public Aid,
now Healthcare and Family Services. |
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Medicaid Peer Review Organization
for the Missouri Department of Social Services. |
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Provided health care utilization
and quality assurance services by meeting and exceeding contract
requirements in eight states. |
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Reduced the average general
medical care stay from 4.4 days to 2.8 and the average acute
inpatient psychiatric stay from 13.1 days to 8.9, and realized
a cost benefit ratio of 1:10 for a state government client serving
nearly 2 million Medicaid beneficiaries. |
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Focused
quality studies and special projects on a variety of healthcare
topics. |
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American Health Quality
Association (AHQA) member and active participant since its inception in 1973. |
