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Health care precertification, also known as prior authorization, is an essential component of comprehensive utilization review.
Permedion has a demonstrated ability to deliver financial benefits through implementation of precertification programs. For example, Permedion successfully implemented a precertification program for a home health client that saved almost $20 million in the first 14 months of operation.
Our precertification services promote appropriate utilization of inpatient, outpatient, and home health care treatment, thereby effectively managing associated costs. Processes and protocols are designed to generate timely, professional, and consistent determinations. We have received full URAC accreditation under the standards for Health Utilization Management.
Permedion can manage the entire precertification process for you. Before care is delivered, our nurse reviewers evaluate the clinical information, obtained by fax, phone, or mail, against established online medical criteria. Cases that do not meet medical necessity or level of care criteria are referred to a physician advisor for final consideration. Our appeals process includes final evaluation by a peer-matched physician reviewer.
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