Clinical Support
Maximize Approved Treatment Days
Expert clinical review services ensuring medical necessity documentation and securing authorization for the treatment your patients need.
The Challenge
Insurance companies are increasingly aggressive about denying or limiting treatment days. Without proper clinical documentation and timely reviews, your patients may be discharged before they're ready—and you lose revenue for services that should have been covered.
Our Solution
VitalBridge's utilization review specialists work alongside your clinical team to document medical necessity, prepare for peer-to-peer reviews, and secure the authorizations your patients deserve. We know what payers are looking for and how to present your cases effectively.
Comprehensive Solution
What's Included
Concurrent Review
Daily review of active cases to ensure continued stay authorizations are secured on time.
Clinical Documentation
Expert guidance on documenting medical necessity to meet payer criteria.
Peer-to-Peer Support
Preparation and support for peer-to-peer calls with insurance medical directors.
Criteria Alignment
Ensure documentation aligns with ASAM, Locus, InterQual, and payer-specific criteria.
Denial Prevention
Proactive strategies to prevent denials before they happen.
Tracking & Reporting
Comprehensive tracking of authorization status and approval trends.
Simple Process
How It Works
Assessment
We review your current UR processes and identify gaps in authorization workflows.
Integration
Our UR team integrates with your clinical staff and establishes communication protocols.
Daily Reviews
We conduct daily concurrent reviews and manage all payer communications.
Optimization
Continuous improvement of documentation practices and approval rates.
Why Choose Us
Key Benefits
More Approved Days
Secure more authorized treatment days for your patients.
Fewer Denials
Proactive reviews prevent costly retroactive denials.
Clinical Focus
Free your clinical team to focus on patient care.
Better Outcomes
Patients get the full treatment they need for recovery.
Authorization Approval Rate
Review Turnaround
More Approved Days
Peer-to-Peer Success Rate
Got Questions?
Frequently Asked Questions
We provide same-day turnaround for urgent concurrent reviews. Our team monitors cases daily and can respond to payer requests within hours when needed.
Yes, we prepare your clinical staff for peer-to-peer calls with detailed talking points and documentation summaries. We can also participate in calls when appropriate to support your case.
We're experts in ASAM criteria for substance abuse, Locus for mental health, InterQual, and payer-specific medical necessity requirements. We ensure your documentation aligns with whatever criteria the payer uses.
We establish daily communication protocols with your clinical staff, integrate with your EHR for documentation review, and provide training on medical necessity documentation best practices.
We immediately initiate the appeals process, preparing clinical summaries and supporting documentation. Our team handles expedited and standard appeals, and we track all cases through final resolution.
“Our authorization denials dropped by 60% after partnering with VitalBridge. Their UR team knows exactly what payers are looking for and helps our clinical staff document appropriately.”