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Clinical & Regulatory Guidance

Our consulting practice consists of nationally recognized physician advisors, experienced care management nurse clinicians, and health care operations experts. These industry thought leaders and clinical management specialists provide clients with innovative and transformative insights.

CARE MANAGEMENT

Deliver whole-person care models by innovating data analysis for risk assessment, transparent reporting of outcomes, and effective engagement and communication strategies.

UTILIZATION REVIEW

Ensure healthcare services are being used appropriately and efficiently with innovative business rules, portal design, and automated authorization workflow processing.

APPEALS & GRIEVANCES

We implement state of the art workflow management tools for auditing and reporting to help meet regulatory requirements and accreditation standards.

QUALITY IMPROVEMENT

Partner with Impresiv Health to drive reporting, workflow optimization, and quality improvement initiatives for HEDIS, CAHPS, NCQA, and CMS.

COMPLIANCE & AUDIT

Impresiv Health specializes in audit readiness, policy and procedure development, and providing CMS, URAC, and NCQA Guidance.

VALUE BASED STRATEGY

Our consultants provide insight and guidance into best practices and productivity improvements to enhance operational, financial, and quality results.

CARE MANAGEMENT SOLUTION DESIGN

Engage our team to bring best practices, proven methodologies, and decades of care management knowledge to either implement a new system or redesign your existing solution.

CARE TRANSFORMATION

Implement a clinical model that is scalable enough to meet the needs of commercial, Medicare, or Medicaid product lines and sustainable to exceed the ongoing regulatory requirements of CMS, NCQA, and URAQ.

BUSINESS TRANSFORMATION

We help with the redesign of:

  • Program Descriptions
  • Policy & Procedures
  • Standard Operating Procedures
  • Correspondence/ Letters
  • Operational & Regulatory Reports
  • Workflow & Automation Strategy
  • Training & Development
  • Stratification Techniques

Ready to get started?

Contact us to learn more about our Clinical Service capabilities and expertise.

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