Utilization Management

Improved value-based care.
Increased patient satisfaction.

HOM’s comprehensive Utilization Management service helps you prevent claim denials and deliver the required care at the right time, improving patient satisfaction.

Glossary

Utilization Management

Utilization Management is a process that evaluates the efficiency, appropriateness, and medical necessity of the treatments, services, procedures, and facilities provided to patients on a case-by-case basis. This process is run by — or on behalf of — purchasers of medical services (i.e., insurance providers) rather than doctors. HOM understands that members and providers require a solution that solves the time crunch and works seamlessly with their existing system to process requests on time. Our Utilization Management modules can easily integrate with your organization’s management system and solve the issues in no time.

Our EDGE

Experience. Expertise. Execution.

Enterprise Platform with an intuitive user interface where you get three levels of evidence-based assessment for disease management:

  • Prospective (before the service provided),
  • Concurrent (during the service provided),
  • Retrospective (after the service provided)
  • Prospective (before the service provided),
  • Concurrent (during the service provided),
  • Retrospective (after the service provided)

Compact, efficient and comprehensive workflows with embedded quality checks.

Optimized EDI (278 transactions) capability.

Why HOM

Improve procedural efficiency.

Our software is streamlined to take only 2 minutes to view an authorization request in the portal.
With the software’s real-time updates and notifications and flexible architecture to meet specific requirements, HOM offers a user-friendly interface with a reduced turnaround time. All these features provide benefits to:

Patients

Get lower costs, more effective treatments, and fewer claim denials.

Healthcare Providers

Get fewer claim denials, lower costs, more effective treatments, better data, and better resource deployment.

Insurers

Get lower costs, better data, and the efficient evaluation of new treatments and protocols.

Know more about our capabilities in Utilization Management

    We would like to hear from you!

    If you have any questions, comments, or feedback, please don’t hesitate to reach out to us. Our team is ready to assist you in any way we can.