Goals of the program:

• Ensure patients receive the most cost-effective, and highest quality care
• Work with providers and patients to achieve health promotion and management
• Facilitate patient discharge within a suitable length of time
• Promote judicious use of resources
• Establish patient/family participation in care and achievement of established goals
• Ensure patients receive all necessary services from the appropriate provider

Highly Experienced Staff
CSG's Utilization Management staff includes full time, on-site Medical Directors, Specialty Physician Advisors, experienced Nurse Case Managers and Utilization Review Pre-certification nurses, each with an average of over 20 years experience, along with ancillary support staff. Case Managers are specialized in managing high risk, high dollar claims including cardiac disease, transplants, high-risk maternity with neonatology, oncology and behavioral health.

We benchmark to National Standards
Medical necessity determinations are based on nationally recognized clinical criteria developed by InterQual®. In addition, we employ department guidelines based on medical research and best practice guidelines for particular geographic areas. This ensures quality, cost-effective health care without compromising necessary
medical care.