Increasing Efficiency with Health Plan Case Reviews in Utilization Management

Health plans and providers alike are increasingly being asked to “do more with less,” but it’s harder for these groups to align on treatment and payment decisions when manual processes are in place.

Xsolis worked with health plan customer, Humana, and its Medicare Advantage utilization management (UM) teams to capture resource spend for authorization requests and clinicals – how much time could Xsolis solutions save Humana over traditional UM methods?

Conducted over a three-week reporting period, this payer time study reveals significant efficiency gains over fax and EMR access when using Xsolis solutions, including faster clinical review times and increased first-touch determinations.

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