MRC’s effective Utilization Review services help health care insurers and hospitals by critically evaluating medical necessity.

We provide criteria-based evaluation of the medical necessity for admission, delivering significant bottom-line results through effective outsourced solutions. MRC helps hospitals analyze and manage the important task of properly statusing Medicare cases as they enter your doors.

Benefits

Explore the various benefits of MRC’s Utilization Management solution:

Precision

With MRC’s Utilization Review, your team will classify admission status correctly the first time.

Responsiveness

MRC’s remote utilization nurse workforce is the largest in the industry, and is there to provide off-site support 24/7.

Coverage

MRC’s highly-experienced RNs provide critical coverage during those hours in-staff nurses may be overextended, such as on nights and weekends.

A Bird’s-eye View

As an independent third-party, our feedback in the review cycle helps facilitate awareness and discussion around root issues that may become more challenging.

What We Provide

MRC’s Utilization Management solution serves as an extension of your case management department. With our utilization review service, we provide:

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Analyses performed to meet InterQual criteria standards

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A customized work product created by our expert Utilization Review nurses

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A national network of physician advisors for secondary review

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Condition Code 44 compliance

Forgo the Call Button

With MRC’s Utilization Review, there’s always a nurse by your side to support medical necessity efforts.