Utilization Management
The Lucent Health Commitment
Lucent Health’s commitment to managing healthcare quality and cost means offering superior Utilization Management services, including Prior Authorization, Concurrent Review, Retrospective Review, and Appeals.
Our URAC-accredited Utilization Management program ensures members receive the care they need—including referring members to large case management/complex care management when appropriate—as well as ensuring savings opportunities.
Our Prior Authorization program delivers an experienced team of clinical professionals—licensed registered nurses and/or physicians—to review all ordered inpatient activity, outpatient surgeries, various diagnostic procedures and other tests for appropriateness. UM nurses work with providers to support members in coordinating medical services and care.
The Lucent Health Commitment
Lucent Health’s commitment to managing healthcare quality and cost means offering superior medical claims management programs and services, including Pre-Certification/Utilization Management (UM).
Pre-Certification/UM ensures members receive the care they need—including referring members to large case management/complex care management when appropriate—as well as ensuring savings opportunities.
Our Pre-Certification/UM program delivers an experienced team of clinical professionals—licensed registered nurses and/or physicians—to review all ordered inpatient activity, outpatient surgeries, various diagnostic procedures and other tests for appropriateness. It ensures that the member receives the highest-quality, most appropriate and most cost-effective services possible.
