Our utilization management solution provides a means to ensure appropriate use and setting of services that health insurers (payers) find indispensable. We offer several different methods of utilization control that examine medical necessity and appropriateness for the level of service and are meant to safeguard against unnecessary utilization of care and services. We work with our customers to align their programs.
Using Alliant's Web-based utilization management tool-Quantum XL™-for service authorizations, we are able to provide assistance in appropriate allocation of resources by:
- Helping with fiduciary responsibilities
- Provide prior authorization reviews
- Produce retrospective reviews and data analysis
- Provide real-time reviews
- Identify candidates for more intensive medical management
Not only does Quantum XL streamline the utilization management process, it reduces the administrative burden on providers, freeing up time that can go back to the practice of medicine.
The impact of utilization of a prior authorization requirement for certain procedures is the foundation for making appropriate policy decisions, as well as capturing wasted time, eliminating unnecessary procedures, and saving money.