What is Utilization management? It is the evaluation of the appropriateness, medical need and efficiency of health care services procedures and facilities according to established criteria or guidelines and under the provisions of an applicable health benefits plan. Utilization management describes proactive procedures, including discharge planning, concurrent planning, pre-certification and clinical case appeals. It also covers proactive processes, such as concurrent clinical reviews and peer reviews, as well as appeals introduced by the provider, payer or patient. 

We have a modern, well-staffed telephonic Utilization Management department. Dobson and Associates, LLC has a team of experienced and professional Utilization Management Specialists who provide expert review of :

· Inpatient and Outpatient medical procedures;

· Inpatient and Outpatient Psychiatric Services;

· Home Health and Hospice Care;

· Rehabilitation Therapy;

· Dental Review;

· Pharmacy Review including IV antibiotics, TPN, Specialty Drugs, Off Label Drug Utilization, etc;

· Durable Medical Equipment Review;

· International Procedures, Medications, and Services