A partnership approach in care coordination that results in accurate patient status and reduced denials.

With the shift to value-based & patient-centered care, it is vitally important to understand how an effective care management plan can save you time wasted on inaccurate patient status and reimbursement lost from denials.

That’s why our care management and utilization review services work directly with your care team members and physicians to develop and implement a successful and robust care management workflow that determines patient status at the onset of admission. We conduct continued stay reviews to consistently verify that documents meet medical necessity. These robust utilization reviews have helped hospitals and health systems improve care efforts throughout their organization and increase their cash flow.

The McBee Advantage

Managing patient status starting at the point of admission is imperative to minimizing denials down the line. Our utilization review team verifies that documentation meets medical necessity requirements utilizing hospitals’ approved evidence-based criteria, identifying missing and insufficient documentation. By initially identifying accurate patient status, denials are reduced, observation rate is more reflective of the care provided, length of stay is better managed and opportunity for additional revenue is identified.

Paired with our operational assessment and executive reporting, we can identify patients trends and drive care management improvement throughout your organization.

  • Remote, first-level utilization review coverage any time: overnight, weekend, and holiday shifts

  • Over 100,00 first-level reviews conducted by our clinical experts

  • Remote, real-time first-level utilization review coverage any time

  • Expert application of InterQual® and MCG® Guidelines

  • Emergency department, inpatient, or PRN case review support options

  • Care team members & Case managers with an average of 15 plus years of experience

Video Blog post Case Study Care management reviews lead to 4% increase in net patient revenue Learn More

The Ins and Outs of a Successful Utilization Management Program


Case Study
Utilization Review Program Recovers $1.8M in Revenue


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