Review Services | Cultural Competency Consulting
Independent Review
- Clinical Review Network
- Contact Us
- Join Our Team
- Review Services
- Independent Review Home
- Pathway Home
Additional Links
External Links
Review Services
Pathway adheres to an established and proven independent review process comprised of well-defined sub-steps and decision points to complete the review. Pathway provides a variety of independent review services, including:
Quality and Utilization Management
Pathway’s utilization management program performs traditional Quality and Utilization Management as well as customized focused reviews on high-cost cases. Our highly qualified and experienced staff can customize our UR services to meet your needs:
- Pre-certification, concurrent review, and retrospective review
- Medical necessity and experimental/investigational reviews
- DRG validation/billing
- Inpatient/outpatient audits
- Review of day and cost-outliers
- Review of short-stay admissions
- CPT validation/outpatient coding
External Review
Pathway specializes in appropriate utilization of health services and review of quality of care that meets practice guidelines. Our reviews offer the depth of expertise and experience to ensure that our clients receive timely, high-quality, objective reviews:
- Focused quality review, quality of care review
- External appeals, experimental/investigational reviews
- Medical necessity, case consultation
