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Precertification -
Preauthorization At DiversiMed, Inc. we believe that
preauthorization and precertification are the cornerstones of cost containment. It
is through professional prospective utilization review that you begin to maximize your
healthcare dollars -- by identifying potentially costly claims before the spending starts,
not after.
Our staff is comprised of fully licensed healthcare professionals, each
of whom is clinically expert. Physician Advisor support, from a
clinician who is Board Certified in
Utilization Review and Quality Assurance, is available for all denials.
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Your
benefit guidelines are the basis we will use to establish the services that we preauthorize or precertify for your insureds, thus delivering custom tailored cost containment. |
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There are three components of the DMI
utilization review process:
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| Fast Response is Essential |
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Response time is immediate at DMI
for calls received during normal business hours -- our Utilization Review
staff is always available from 8:00 am to 5:00 pm Eastern Standard Time.
During nonroutine hours, calls are answered by our live operator and
addressed within two hours of the next business morning. There is
always a Registered Nurse on call for emergencies. The DMI toll free
numbers are national lines, for the convenience of your plan members. |
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| Reports Tell You the Whole Story |
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Reports are our specialty.
You receive same day hard copies via fax of all Utilization Review determinations, with
monthly outcome reports. Our database is quite purposely intricate, expressly for
the purpose of delivering collected data in any indexed format you desire. |
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You can expect savings similar to those
shown below when DMI precertifies and preauthorizes healthcare claims for your
insureds: |
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| Utilization
Review Saves Healthcare Dollars |
| Group Name |
Number
of Lives |
LOS
Requested |
Initial
Days
Certified |
Certified
Extensions |
Days
Saved |
Savings
R and B |
Case
Load |
A |
4,377 |
294 |
135 |
86 |
73 |
$32,832.00 |
48 |
B |
703 |
4 |
3 |
0 |
1 |
$386.00 |
1 |
C |
1,912 |
72 |
42 |
14 |
16 |
$10,677.00 |
10 |
D |
979 |
143 |
69 |
37 |
37 |
$17,365.00 |
19 |
E |
18,130 |
977 |
480 |
269 |
228 |
$107,021.00 |
205 |
F |
2,038 |
59 |
26 |
14 |
19 |
$11,017.00 |
16 |
G |
1,517 |
87 |
37 |
23 |
27 |
$14,714.00 |
15 |
H |
1,284 |
65 |
23 |
30 |
12 |
$5,132.00 |
8 |
I |
513 |
7 |
3 |
1 |
3 |
$1,302.00 |
3 |
J |
195 |
24 |
16 |
6 |
2 |
$892.00 |
3 |
Totals |
31,648 |
1,732 |
834 |
480 |
418 |
$201,338.00 |
328 |
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Call DiversiMed today! Begin
maximizing your healthcare savings ... and provide your insureds maximum benefits through
precertification and preauthorization of services based on your
guidelines.

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DiversiMed,
Inc.
P.O. Box 21505
Tampa, FL 33622-1505 |
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Toll-free
(US/Canada): (800) 282-7032
Direct: (813) 628-4488
Fax: (813) 620-3733
dmi@diversimed.com
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Home Page |
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Copyright ©
2000-2009, DiversiMed, Inc. All rights reserved. Trademarks not owned by DiversiMed, Inc. are owned
by other companies. Rights to design elements such as photos, graphics and computer
programs remain the property of their respective owners. Some of the images used herein
were obtained from: Corel Corporation, 1600 Carling Avenue, Ottawa, Ontario, Canada K1Z
8R7 and IMSI's MasterClips Collection, 1895 Francisco Blvd. East, San Rafael, CA
94901-5506, USA |
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