bServed’s UM system for Health Plans & IPA's advances and facilitates the best patient outcomes, which are always coupled with the dual goal of cost savings.

With care coordination, patient engagement, and transition care models. bServed’s systematic, efficient, and cost-effective program will simplify Case Managers’ responsibilities and ensure lower costs overall.

When over-burdened nursing staff are laden with reporting requirements, patient care suffers, and hospitals lose revenue through inaccurately processed paperwork. bServed works closely with Hospital Coding Teams to ensure that all diagnoses are coded and billed properly.

• Clinically appropriate site-of-care choice.
• Appropriate level of care for the patient’s condition.

• Hospital medical records audits ensuring accurate coding of diagnoses.
• Assuring use of in-network providers.

Through Transition Care, we

• Identify patients with post-acute needs, such as those at risk for readmission.
• Prioritize, and even intervene as necessary.
• Evaluate readmitted patients to identify and implement strategies for improvement.

For Patient Engagement, we

• Use improved data sets to identify more potential members.
• Follow Consumer engagement trends, including micro-targeting.
• Utilize patient family engagement.
• Enhance member contact information and leverage multiple channels to reach members.

For Avoidable Delays/Days, we:

• Utilize a validated system/defined methodology to track avoidable delays/days.
• Prioritize, and even intervene as necessary.
• Evaluate readmitted patients to identify and implement strategies for improvement.

For Denials/Appeals, we

• Proactively initiate claims denials when:
• Inappropriate level of patient care was utilized.
• Treatment was not medically necessary.
• Inappropriate diagnoses were coded.