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Case Management & Utilization Review

By definition: “Case Management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual’s health needs, using communication and available resources to promote quality, cost-effective outcomes”.

At American Healthcare Audit Professionals we provide independent nurse Case Management services in a timely, efficient and professional manner for our clients. All of our experienced Nurse Case Managers have extensive clinical background in different areas of healthcare including critical care and worker’s compensation.

We provide our customized and comprehensive services for hospitals, medical providers, insurance companies, managed care providers, TPA, attorneys. Just to name a few

“Making a difference where it counts!”

Auditor's Corner

"Documentation errors and omissions can clearly put hospitals and physicians at risk for denials. Most physicians don't understand the link between what they write in a medical record and what the hospital, and they get paid. Nor do they understand the very real risks of fraud and abuse charges that can result from patterns of errors. Understandably, healthcare providers put patient care first and we wouldn't want things any other way. When the doctor is called to see a patient with chest pain, writing a detailed note is just not the first thing on his or her priority list. Too often though, providing excellent patient care is used as an excuse for very poor documentation." Read on

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    • Medical Chart Auditing/Hospital Bill Review
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