• Skip to primary navigation
  • Skip to main content
  • Skip to footer

Acentra Health

  • Solutions
        • Advanced Processing Solutions

        • Claims & Encounters
        • Financial Management & Reporting
        • Member Services
        • Clinical Services & Solutions

        • Care Management
        • Quality Oversight
        • Assessments, Eligibility, & Enrollment
        • Data Analytics

        • Machine Learning
        • Data Interoperability
        • Provider Solutions

        • Provider Engagement Services
        • Provider Screening & Enrollment
  • Technologies
    • evoBrix X™
    • Atrezzo
  • About Us
    • Leadership
    • News & Events
    • Clients & Testimonials
    • Locations
  • Resources
    • Blog
    • Case Studies
    • Contract Vehicles
  • Careers
  • Contact Us
    • Become a Peer Reviewer
  • Request a Demo

Search iconRequest a Demo

Above, discussion and doctors in a meeting about healthcare, medical agenda and schedule at clinic. Banner, graphic and team of medical employees planning, talking and working on nursing strategy

Utilization Management

The first line of defense to manage healthcare costs.

Contact an Acentra Health Expert

Over 20 years of experience providing Utilization Management services to complex populations

Acentra Health’s Utilization Management program promotes quality and cost-effective healthcare and member well-being that ensures appropriate utilization of services. We currently provide UM in eight states and bring broad knowledge and industry best practices to maximize quality care and cost-effective outcomes across the continuum of care.

Acentra Health's decades of Utilization Management experience with proven outcomes are evidence of our ability to support and ensure our client’s initiatives are advanced and positive outcomes are created for their members. Our solution is tailored to provide intelligent value by leveraging our clinicians and national expert resources.

Our URAC accredited
Utilization Management
solution includes:

  • Prior authorization of inpatient and outpatient services
  • Surgical procedures and transplants
  • Behavioral health services
  • Extended outpatient therapies
  • Radiology services
  • Durable medical equipment
  • Retrospective review
  • Prior authorization for organ/ tissue transplants and nursing services
  • Concurrent review
  • Discharge planning and care management program referral
  • First and second level appeals
Utilizationmanagement2

Our 360-Degree Approach to Care Management

Care
Care Coordination

Leveraging cross-disciplinary insights to create a full-scope view of patient health.

Care Link Box

Boardcheck
Case Management

Identifying and improving outcomes for high-risk, high-cost beneficiaries.

Care Link Box

Pharmacy
PHARMACY MANAGEMENT

Increasing pharmacy efficiency, accountability, and compliance with expert guidance.

Care Link Box

Handshakeicon1
EMPLOYEE ASSISTANCE PROGRAM (EAP)

Supporting employee wellness and productivity with comprehensive services.

Care Link Box

Acentra Absence Management 1
ABSENCE MANAGEMENT

Tracking and analyzing employee absences to identify trends and opportunities.

Care Link Box

Ctaimage2

Get Started with Acentra Health

Connect with an expert from our team and learn more about how
Acentra Health's solutions and services can benefit your organization.

Request a Demo Contact Us

Footer Logo

Headquarters
1600 Tysons Blvd,
Suite 1000
McLean, VA 22102

Clients Sites
Privacy Policy
Web Accessibility
Site Map

dashicons-linkedin dashicons-twitter dashicons-instagram

Sign Up for Acentra Health Updates

"*" indicates required fields

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply

Copyright © 2023 Acentra Health. All Rights Reserved.