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Our Services

Our Unique Process

How the first level review process works.

As regulations tighten it’s important to keep your process as lean as possible while still bolstering patient satisfaction and care. Case Management Innovations is built to be a simple, easy way to help utilize your facilities resources and ensure case management regulations are followed by adding one simple step to your patient care in the ED.

  • Correct LOC placement recommendations for admits from the ER
  • Verbal Recommendations within 15 minutes
  • Written reports of recommendations and criteria met by the patient
  • Education and training for all users
  • 24/7 Support

When to request a case review.

    • Anytime a case has been identified as potential admission.
    • When patient is ready for admission, but before admission orders are written
    • Cases that are questionable regarding their appropriateness for admission are reasonable as well.

We Made It Simple

Hit the "Easy Button"

CMI has taken all of the steps to provide your facility with a 24/7 support tool, the “Easy Button”. With just a few clicks your staff is provided case management by trained professionals.

  • Correct LOC placement recommendations for admits from the ER
  • Verbal Recommendations within 15 minutes
  • Written reports of recommendations and criteria met by the patient
  • Education and training for all users
  • 24/7 Support

Additional Services

Our nurses have decades of experience addressing our client’s most pressing business problems. We solve our client’s problems in an agile manner that reduces complexity and leads to early success. This allows our clients to focus on their future knowing that their present is secure. Our solution offerings work together to provide our clients with everything they need to transform into a more cost-effective, quality-focused organization.

Hospital Utilization Review Services

Medical institutions have a huge responsibility to ensure that patients receive high quality care with an appropriate treatment plan. CMI is here to help make that happen. We offer review of your hospitals current utilization review program and will suggest strategies that can be implemented to improve program efficiency.

Having an efficient utilization review program benefits the hospital as well as the patient. Efficiency enables you to better utilize hospital resources while holding down cost for the facility and the patient.

Furthermore, implementing an efficient UR program will go a long way in preventing fraud from occurring on your premises. It’s an added level of security, and with us facilitating the checks, you can be sure that every detail will be closely scrutinized.

Don’t settle for less, when it comes to hospital utilization management. Contact Case Management Innovations today.

Minimizing Wasted Resources

It’s undeniable that providing better care packages has tremendous benefits for patients. Regardless of how light or how serious the condition is, providing the correct treatments and billings for each case is integral to efficient service and patient care- which is why having an efficient utilization review manager works to the practice’s benefit. Hospitals are a necessity, and it is vital to ensure that the care provided to every patient goes as smoothly as possible. Plus, such efficiency enables you to better utilize hospital resources.

Medications, room allocations, and staff actions are among the many things that determine when utilization management in hospitals is necessary. If you see an increase in expenses across the board but little improvement elsewhere, consider what we can bring to your operation. We minimize wasted resources, maximizing our expertise so that you can do the same with yours.

Honesty &
Protection

Furthermore, implementing UR will go a long way in preventing fraud from occurring on your premises. It’s an added level of security, and with us facilitating the checks, you can be sure that every detail will be closely scrutinized. There is a mass of data involved, and we are at full strength when it comes to the tools and strategies required to process all your medical care documents.

Don’t settle for less, when it comes to hospital utilization management. Contact Case Management Innovations today.

After Hours Case Management

Many standard case management tasks can be accomplished remotely. That is especially true after regular business hours and weekends. CMI has the ability to work with your facility to manage those tasks to meet your needs. Our case managers can integrate with yours to make case management as seamless and cost-effective as possible.

We welcome the opportunity to discuss our solutions to your after-hours case management needs.

Continued Stay Management

After admission, patients should be assessed daily to determine their level of continued care. CMI Case Managers can review a case at any point in the admission to assist in the concurrent review. We will utilize your standardized tools for these reviews to maintain consistency with your process.

CMI concurrent reviews can serve as a second opinion to support the on-site Case Manager, or to serve in a primary role when the on-site Case Manager is unavailable

Denial Management

Managing denials from Recovery Auditors or other payors can be complicated and require a level of medical expertise. CMI can manage the denial process for you. Simply turn the process over to our team and we will do the heavy lifting while keeping you involved with the process at any level you desire.

 

 

Post Discharge Patient Calls

Managing readmissions is an important component of maintaining your organization’s financial success. One of the more effective means of reducing readmissions is post-discharge phone calls. These calls can ensure that your discharged patients have followed through with their care plan. If there are any problem areas, the patient will be connected with the appropriate resource to resolve the problem.

 

Education & Training

CMI has a range of educational offerings. Most carry CEU credits and can be live on-site events or web-based. Whether the need is for the physician medical staff regarding appropriate admissions or for the hospital’s staff regarding utilization management, CMI can cover it. If there is a need for education that is not already in our library, we will create it.