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Adventist West, a large health system with more than 3,000 beds and 28 acute hospitals, is on its way to achieving exception-based utilization management (UM) by redesigning and automating their utilization review program.

In this webinar, UM leaders demonstrate how they launched a clinically driven initiative that had a positive effect on the revenue cycle. This has resulted in fewer avoidable medical necessity denials, reduced length of stay and healthier financials overall. Regina Berman, RN, MA, value-based care executive at Adventist West, highlights the process changes paired with advanced technology, such as AI-driven medical review automation with InterQual® AutoReview, that led to their success.

Key takeaways
  • Adventist West implemented a centralized, exception-based UM program.
  • InterQual AutoReview with AI and automation was used to streamline UM.
  • The UM transformation resulted in sustained achievements that had a positive effect on the revenue cycle.Ìý

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