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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

"The recent announcement by CMS regarding its modification of additional documentation requests for institutional providers during fiscal year 2010 has generated considerable response from providers seeking clarification about tax identification numbers and definitions of terms like "campus." Each RAC annually is expected to establish a per-campus cap on the maximum number of medical records it can request per 45-day period. " Read on

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    • Medical Chart Auditing/Hospital Bill Review
    • Certified Coding
    • Case Management and Utilization Review
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