WHAT IS UTILIZATION REVIEW? Utilization Review (UR) is the process insurance companies use to review a request for medical treatment; to approve, authorize or decline services. Insurance companies do this in order to prevent unnecessary treatment, duplication of services, prevent fraud, abuse and waste of unneeded service dollars. The process begins with the collection of information, including the symptoms, diagnosis, lab results, medical and clinical criteria pertaining to the condition. HOW IMPORTANT IS UTILIZATION REVIEW TO MY COMPANY? Utilization Review is one of the most critical aspects of any behavioral health organization. It is the starting point of the billing process and crucial in obtaining payment. It is by far, one of the most overlooked and disregarded areas of the billing process. Improper and/or poorly managed UR will not only limit profitability but the client’s length and access to treatment. HOW CAN UNLIMITED UTILIZATION MANAGEMENT HELP ME? For facilities that do not offer in-house Billing or Utilization Review, UNLIMITED provides an outsourced solution for an organization’s UR needs. UNLIMITED sets itself apart from its competitors by focusing on communication. Communication with the facilities intake/admissions, medical and clinical teams, so that UNLIMITED’s UR team has a clear picture of the client’s case prior to and upon admissions. This level of service and attention to detail is unparalleled and is what sets us apart from other companies. Our team of trained professionals are available to effectively manage this process for you. OUR UTILIZATION MANAGEMENT PROGRAM FEATURES: • A panel of specialty consultants including medical and clinical professionals • Client discharge planning and short term case management to facilitate continued care • Detailed Utilization Review reports customized to fit your company’s needs • Claims negotiation for facility and lab fees