MRx Navigate: Navigate UM
What is Navigate UM?
Navigate UM is a utilization management program that uses a combination of insights and innovation to ensure patients receive proper medical and behavioral healthcare. This fully-integrated utilization management program covers prior authorization, concurrent review of inpatient admissions, transition of care assessment and appeal management.
We understand that each organization is unique, so to best meet your needs, we offer the flexibility of selecting Navigate UM as a standalone offering.
What we offer:
Our expert team of intake specialists, nurses and physicians perform these services, which are compliant with NCQA standards, and offer a comprehensive suite of reports to track trends and identify opportunities.
Expertise
Providing comprehensive peer-to-peer review
Efficiency
Efficiently managing turnaround times
Accuracy
Providing medically necessary care based on nationally recognized clinical guidelines
Prevention
Preventing fraud, waste and abuse
Guidance
Referring members into care management
Support
Minimizing readmission through transition of care
Who can benefit from Navigate UM?
- Health plans
- Employer groups
- Government entities
- Third-party administrators
Please note that individual program implementation is dependent on plan size and other factors. We will partner with you to create a custom solution that best fits the needs of your unique population.
Let us show you how Navigate UM can reduce your population’s health risks.
Connect with us today! Want more? Check out our MR Navigate suite of integrated solutions here.