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Unlimited is a specialized utilization management company serving substance abuse and mental health treatment providers. Our expertise lies in partnering with facilities and billing companies in these clinical areas to provide comprehensive utilization review (UR) services.
In the Behavioral health industry today, one of the most common and expensive mistakes facilities make is to assume that UR has a “one size fits all” answer. This is just not true. We offer a new and different solution, a program tailored to the size, needs, and type of UR you need. We will work with your team to create a unique plan for your facility, and your facility only, outlining all possible areas for success and common pitfalls. With a deep understanding of the unique challenges faced by behavioral health organizations, our team offers a streamlined UR solution that maximizes reimbursements and client care.
Unlimited is a specialized utilization management company serving substance abuse and mental health treatment providers. Our expertise lies in partnering with facilities and billing companies in these clinical areas to provide comprehensive utilization review (UR) services. With a deep understanding of the unique challenges faced by behavioral health organizations, we offer a streamlined UR solution that maximizes reimbursements and client care.
With the sole focus on behavioral health, it makes it easy to know you are in the right hands. We provide “In-house” services without the overhead and management headaches. A new concept, concierge UR designed around your facilities needs. Staffing, pricing, tailored to what you need.
We can also offer A’ La carte services such as billing and claims. We also offer Clinical and Medical training on documentation ensuring maximum length of stay and audit-free chart submissions.
Utilization review refers to the process insurance payers use to evaluate the medical necessity, appropriateness, and efficiency of healthcare services. For substance abuse and mental health treatment, UR plays a critical role in obtaining authorization and payment for services rendered. The process involves a detailed review of clinical information such as the client’s symptoms, diagnosis, treatment plan, progress notes, lab results, and the application of evidence-based clinical criteria specific to the presenting condition. We are the team that gets you paid before billing ever submits a claim.
UR ensures insurance payers evaluate the medical necessity and appropriateness of services, securing authorization and payment for treatment.
UR involves reviewing clinical details like diagnosis and treatment plans, ensuring payment is authorized before billing submits a claim.
Proper utilization management is paramount for behavioral health providers. It serves as the gatekeeper to the billing and reimbursement process, directly impacting your facility’s profitability and the continuity of client care.