cmata@essdoc.com
1-866-931-8882 - Toll Free

Leading Case Management

Your All-in-One Solution for Case Management

CMI has over 10 years of experience in first-level case reviews. We work with your existing case management team to provide 24/7 level of care recommendations based on nationally recognized guidelines to ensure your patients are placed in the correct level of care from the ED.

office-stm-slider
homepage-sliderfront

Quality Care

Develop a Trusted Level of Care

Case Management Innovations is a company dedicated to the support of Case Managers and Utilization Review Managers by providing 24/7 remote coverage.

Our team of Case Managers, Clinical Nurses, Physicians, Billing/Coding Specialists, Healthcare Administrators, and Attorneys are focused on providing the tools and services needed to ensure the appropriate patient flow from admission through any potential denial periods.

By providing a 24/7 initial level of care review for patients presenting to the ED, the risk of placing a patient in an incorrect status decreases significantly. When the level of care is correct from the beginning, there is less work on the back end and a decrease in denials.

Quality Care

Develop a Trusted Level of Care

Case Management Innovations is a company dedicated to the support of Case Managers and Utilization Review Managers by providing 24/7 remote coverage.

Our team of Case Managers, Clinical Nurses, Physicians, Billing/Coding Specialists, Healthcare Administrators, and Attorneys are focused on providing the tools and services needed to ensure the appropriate patient flow from admission through any potential denial periods.

By providing a 24/7 initial level of care review for patients presenting to the ED, the risk of placing a patient in an incorrect status decreases significantly. When the level of care is correct from the beginning, there is less work on the back end and a decrease in denials.

Proper Case Management

The Business of Medicine

Case Management at all levels of care in the hospital setting from ED to Discharge has become a vital part of healthcare. Most critical access hospitals have one person acting in several roles to manage all of the Case Management needs for the entire facility. That person has to be aware of all the patients admitted to the facility, their discharge planning, denial management, utilization review, and sometimes even act as a social worker.

Utilizing CMI to support your case managers remotely will allow information to seamlessly pass between all parties giving the onsite case managers the knowledge needed to prepare a plan of care for all new admissions.

Highly Focused

Critical Access Focused

The delivery of case management services in the Critical Access hospital differs significantly from those delivered at a metropolitan medical center. Resources can be scarce and direct feeds of pertinent information are often lacking. Yet Critical Access hospitals are still held to the same standard of care and have even bigger financial pressures. Case Management Innovations endeavors to work with our client partners to fill the gaps in your processes through the support of your on-site case managers.

The goal at Case Management Innovations is to continue to identify areas of need and opportunities to meet them. If our current services don’t meet your needs, we will work with you to find solutions.

CMI provides a seamless extension of your staff.

Handling first-level ED reviews after 5 pm and on weekends is a challenge for smaller facilities. The ER volume typically doesn’t justify the expense of around-the-clock case management. Our case management nursing staff is available when you need us.

Access our nurse reviewers to augment your local resources 24 hours a day. Our reviewers are trained and well-versed in InterQual® and Milliman Care Guidelines (MCG).

If your ED is tied to your EMR we can have real-time access to your clinical documentation, this enables our nurses to provide admission review without disrupting your workflow.

We use your Guidelines (you need to have a valid license for your guidelines) for Evidence-Based Reviews

  • Around-the-clock nurse reviews from CMI
  • Eliminate any gaps in coverage with our 24-hour a day, seven-day a week review service. Our nurses are always available. That includes weekends, nights and holidays and when your local staff is on vacation or ill.
  • We use your Guidelines for Evidence Based Reviews
  • Our nurse reviewers are experts in the use of InterQual® and Milliman Care
  • Guidelines (MCG) – we will use your preferred criteria to screen hospital admissions for medical necessity. (you need to have a valid license for your guidelines)

Live Support

24/7 Support to resolve your issues in a flash.

Our solution is a 24/7, 365 days a year remote call center that provides quality reviews at a low cost, increasing your bottom line while avoiding improper inpatient admissions that RAC will target. We use standardized guidelines and have a rapid turnaround.

Effective case managment is just a few clicks away!