ExamWorks provides services such as Independent Medical Examinations (IMEs), Peer and Medical Record Reviews, and Bill Reviews, which are closely related to the Utilization Review space. Additionally, the company is accredited by URAC under Independent Medical Examination (IME) Standards, further indicating its involvement in the Utilization Review space.
Toney HealthCare Consulting provides comprehensive utilization management services, including prior authorization, member and provider engagement, physician review, appeals, and grievances, which are key components of the Utilization Review space.
Cohere Health provides services and platforms related to Utilization Management (UM) and prior authorization, which are closely related to Utilization Review. Their offerings include Cohere Complete™ Outsourced UM and Cohere PaaS™ Intelligent Prior Authorization, both of which involve reviewing and managing the use of healthcare services.
XSOLIS provides AI-driven healthcare solutions focusing on utilization management, which is closely related to utilization review. The company offers solutions tailored for providers, payers, and accountable care organizations, and has a Chief Revenue Officer with experience in improving utilization review and case management processes.
Slingshot operates in the healthcare industry and focuses on analyzing medical records to determine if diagnoses are supported by clinical evidence, which aligns with the Utilization Review space. They aim to save patients money by addressing inflated and erroneous medical bills, utilize AI to automate coding and clinical validation, and offer tools for payment integrity teams, all of which are activities related to Utilization Review.
Develop Health offers AI-powered solutions for medication processes, including Benefit Verification, Clinical Eligibility, and Prior Authorization. These services are closely related to Utilization Review, which involves evaluating the necessity, appropriateness, and efficiency of healthcare services. The company's focus on streamlining prior authorization and verifying patient history against plan criteria aligns with the goals of Utilization Review.
CorroHealth provides a comprehensive range of revenue cycle management solutions, including utilization management, which is closely related to utilization review. They offer services such as admission status reviews and peer-to-peer reviews, which are components of utilization review processes.
Iodine Software's AwareUM platform applies machine learning to prioritize utilization management workflows and provides a dedicated hub for all Utilization Management work, which directly relates to the Utilization Review space.
Allied Benefit Systems offers Allied Care Solutions, a URAC accredited medical management platform, which indicates involvement in the Utilization Review space.
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