Utilization Review & Case Management

CBIZ's Utilization Review and Case Management services consist of registered nurses with a vast amount of experience in both the hospital and payer environment. Our registered nurses can provide support to your organization with key utilization management/case management activities designed to fit your needs. Our vast solutions include:

  • Utilization management assessment
  • Education/instruction healthcare guidelines (InterQual Criteria / Milliman Care Guidelines)
  • Inpatient medical necessity review (commercial & government payer)
  • Short stay medical necessity review (commercial & government payer)
  • Observation stay medical necessity review (commercial & government payer)
  • Emergency department case management services
  • Observation & Two Midnight-Rule Services (S20 Monitor)

CBIZ can work with your organization to identify ways in which your organization can effectively reduce length of stay based on the integration of data findings and case management services. By performing a utilization management assessment, you will uncover many issues contributing to the high length of stay for certain patient populations as well as lower your denial rate for inpatient days.

Key Contacts
Stacy Pereira Stacy Pereira Executive Director
Jeff Lampman Jeff Lampman Executive Director