Kunkel & Associates
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Utilization Review

Kunkel Care Solutions Utilization Review process evaluates medical necessity, verifies appropriate levels of care, and provides proactive discharge planning. With Utilization Review, improved patient outcomes are experienced while health plan savings are maximized.

Our Utilization Review program can be customized to meet your needs.

Services include:

  • Inpatient medical necessity review
  • Continued stay reviews
  • Outpatient services and testing to avoid over-utilization
  • Second opinions
  • Peer reviews
  • Appeals
Utilization Review Case Study

Case Study
Residential substance abuse treatment confinement.

Our Approach
The Utilization Review nurse monitored progress weekly, obtaining both verbal updates and written documentation. Upon completion of the 28 day program, the facility requested additional inpatient days; however a comprehensive outpatient program was coordinated offsetting additional costly inpatient days. Total savings to the plan were approximately $12,000.

Contact one of our Utilization Review Consultants with further questions about the program.

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