UTILIZATION MANAGEMENT

CommCARE manages the authorization process for treatment across the course of patient care--before, during, and after the delivery of health services.

Our Utilization Management services include:

  • Level of care determination

  • Prior authorization

  • Grievances and Appeals

  • Clinical criteria development

  • Quality improvement programs and activities

  • Provider recruitment and credentialing

  • Concurrent review

  • Retrospective review

CommCARE adheres to an excellent  code of ethical business standards.  We are in compliance with federal, state, and local laws and regulations, which include the Health Insurance Portability and Accountability Act (HIPAA).

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