A vital component to the bottom line of any hospital or health system is the Utilization Management (UM) department. Their functions and roles have evolved over time, becoming more complex and integral to patient outcomes, as well as to the overall success of the organization. There is a negative financial impact on organizations that have inaccurate or ineffective UM programs. Therefore, aggressive interventions from UM staff are necessary to aid in the prevention of case denials. A successful and robust UM program can assist hospitals and health systems meet their financial and compliance goals.
Experts from McBee will discuss several aspects of the UM functions and how they impact denials. A checklist will be provided so you can ensure best practices are being adhered to. The webinar will include a case study approach that showcases significant results around increases in revenue and reductions in medical necessity denials.
By the conclusion of this webinar, participants will be able to:
- Explain the importance of centralizing the UM functions.
- Identify the key components of a successful UM program.
- Discuss how a UM program impacts denials.
- Identify best practices of a UM program that can be applied to your organization.
Arrica Canty, RN, BSN, CCM, LNC
Senior Manager, Care Management
Arrica has more than 20 years’ experience in healthcare, with over 17 years as a Registered Nurse, and 14 years in case management. Her contributions to the healthcare field include experiences in hospital, home health, and academia environments. She has a broad base of consulting and operational experience for home health, quality management, utilization review/management and case management, and medicolegal realms. Arrica has worked for McBee in various capacities since 2010. She received her B.S in Nursing from UNC-Charlotte.