The rapid development and availability of new treatments and technologies, combined with escalating costs, create risk of overutilization and unnecessary expense for the plan and the member. inVentiv Medical Management focuses on promoting the right care at the right cost in the right setting. This will result in the best possible clinical and financial outcomes for all stakeholders.
As part of our comprehensive portfolio inVentiv Medical Management provides a variety of healthcare utilization management review services that promote adherence to evidence-based medicine, ensure delivery in the most cost-effective care setting, and are designed to reduce the likelihood of care that is unnecessary or unsafe.
These services include:
Medical Necessity Determinations
To ensure that the most appropriate evaluation for all clinical situations is provided we have assembled a team of board certified physicians with a variety of specialties and subspecialties. Our clinical depth and breadth allows us to provide a single point of service regardless of the care being evaluated.
iProcert™ Utilization Review Service
Using their specialized clinical knowledge in utilization management and evidence from the Milliman Care Guidelines, the iProcert physician and nurse team works in collaboration with the provider to determine medical necessity of healthcare services prior to being delivered.
iProcert™, inVentiv Medical Management’s physician led utilization service, is provided through our business affiliation with American Health Holdings, Inc. (AHH).