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
Credentialing
- 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
