Medical Management Services

HS1 offers a comprehensive array of medical management products and services.

Medical Direction

  • HS1 Chief Medical Officer and Medical Directors have extensive managed care backgrounds
  • They insure that the highest quality of care is delivered in the most cost effective manner
  • They promote direct involvement with Physicians, PCPs, Hospitals and Discharge Planners
  • Specialty-oriented Peer Review Committees oversee episodes of care, grievances, credentialing,  etc.

Authorization Department

  • Treatment Authorization (24/7)
  • Benefit & Eligibility verification
  • Timely referrals to specialists and hospital for inpatient and outpatient services

Concurrent Review

  • Coordination of all inpatient care - from hospitalization to discharge

Case Management

  • Upon discharge, Nurses manage the total continuum of care
  • Insure that the most appropriate, cost effective & timely treatment is provided


  • Primary Source Verification
  • In-house Peer Review
  • Integrated with QI program
  • Comprehensive record keeping & documentation

Quality Improvement

  • Evaluation of Providers for Regulatory Compliance
  • Perform Medical Record and Site Visit Audits
  • Information trending / tracking
  • Quality Improvement Projects
  • Benchmarking & Corrective Action Plans