Observation or Inpatient status,
over the phone 24 hours per day.

After hours medical necessity / utilization review

Welcome to Case Management Innovations

CMI is a company built around case management challenges that can be solved remotely in a quality and cost effective manner. We bring experience in hospital and medicare case management services, hospital administration, emergency department management and utilization review. The problem we face today is that approximately 60% of admissions from the Emergency Department occur after traditional business hours when most hospitals do not have case management services to assist with level of care decisions. The risk of getting it wrong can be costly. CMS estimated $4.4 billion in improper payments related to improper admissions. 24/7 Evidence Based Admission Reviews- 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.

This is particularly evident when certain conditions prevent medical institutions from acquiring an ample labor force. Rural hospitals, for instance, usually suffer this shortage due to lack of accessibility, as well as lack of incentive for potential staff members. Another example would be the competitiveness between big hospitals, when it comes to acquiring and retaining industry talent. With us, you don’t have to worry when you are not able to meet your manpower goals because we will more than make up for the people you can’t hire.

We provide a spectrum of case management outsourcing services that will make hospital case management a lot less cumbersome to your practice. From admissions to denial management to after-hours work, Case Management Innovations will deliver the support you need whenever you need it. Whether it’s on the weekends, after-hours or during your downtimes, or when you have a skeleton staff, our around-the-clock assistance ensures that the place keeps humming and the paperwork keeps going whenever you need it.

We can bring our full range of medical case management services to you. Please let us know what the current challenges are, and let’s discuss how our team can help.