SEATTLE, July 23, 2013 /PRNewswire/ -- MCG (formerly Milliman Care Guidelines), a leading provider of clinical guidelines to healthcare payor and provider markets, has entered into agreements to cover an additional 1,000,000 health plan members with Cite AutoAuth Module.
Cite AutoAuth Module brings the best available evidence to bear on clinical necessity in automating the adjudication of procedure authorization requests. Rather than faxing requests for manual review, providers convey patient data to a health plan using a secure online portal. Cite AutoAuth Module then analyzes patient clinical indicators and makes an authorization determination, often within seconds. Complex cases are sent for review. The process makes utilization management more efficient, helping to reduce staff costs and cases of inappropriate care and improving response times to provider requests. Together, these factors help payors drive reductions in medical costs while maintaining decision quality.
"Our health plan partners are committed to improving healthcare outcomes and providing the right amount of care," said Jon Shreve, chief executive officer of MCG. "Increasingly, they see automated authorization as a means to that end – as evidenced by the additional million members now covered by Cite AutoAuth module. Prior authorization of patient treatment is an opportunity to improve healthcare delivery by putting payors, providers, and patients on the same page. Automated authorization – paired with clinical guidelines – makes the most of that opportunity."
Cite AutoAuth Module is especially attractive to payors with robust utilization management programs – the higher the volume of authorizations performed manually, the higher the potential ROI.
MCG, formerly Milliman Care Guidelines, independently develops and produces evidence-based clinical guidelines and software used by more than 2,200 clients, including 1,200 hospitals and seven of the eight largest U.S. health plans. Updated annually by an experienced team of clinicians, the care guidelines support the care management of a majority of Americans. For more information, visit www.careguidelines.com. (http://www.careguidelines.com)
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SOURCE MCG, formerly Milliman Care Guidelines