services SERVICES
Emergency Department Admission Review Management
Personalized Service
A dedicated senior level member of our team, will be your personal account manager throughout your relationship with Proven Healthcare Solutions, and will provide you with the personal service you deserve.

Flexible Coverage
Proven Healthcare Solutions' Admission Review Management Service provides hospitals and healthcare systems a flexible, cost-effective, turn key solution to address the ever-challenging requirements of ensuring real time, point of service medical necessity review determinations of patients coming in through the Emergency Department. This includes utilization review using latest evidence-based screening criteria to determine the right level of care to be provided to these patients- inpatient, outpatient observation status or discharge for outpatient follow-up.

By taking a Six Sigma, lean manufacturing approach, Proven Healthcare Solutions (PHS) has designed coverage options to accommodate all of your Admission Review Management needs including:
  • Nights
  • Weekends
  • Holidays
  • Specific Shifts
  • Vacation/leaves of absence
You have the choice of any of these coverage combinations, including outsourcing 100% of your hospital's review for medical necessity and appropriateness of setting of all potential new admissions coming through your Emergency Department.

In the new era of an alphabet of healthcare oversight including- Recovery Audit Contractors (RACs), Medicare Administrative Contractor (MACs), Comprehensive Error Rate Testing (CERTs), Payment Error Rate Measurement (PERMs), the Office of the Inspector General (OIG), the Office of the Medicaid Inspector General (OMIG), Managed Care Organizations (MCOs), and many others, PHS enables you to reduce your compliance risk.

Strategically Balancing Hospital Performance with Compliance
Hospitals and Health Systems that select Proven Healthcare Solutions will realize the following benefits:
  • Consistency of medical necessity and appropriateness of setting review for new inpatient admissions
  • Reduction in denied days for inappropriate admissions
  • Use of the latest evidence based screening criteria
  • Maximization of allowable revenue for appropriate assignment of patients to observation status
  • Improved Emergency Department patient throughput
Proven Healthcare Solutions is committed to providing your site with a response within 30 minutes or less, depending upon the complexity, of receiving your request and all supporting documentation.

Transparent Pricing
There are no hidden or surprise costs with our service. Once our hardware and software is installed and VPN connection is provided, you have the choice of either paying on a per-encounter basis or an annual subscription fee based upon your ED volume and historical rate of admissions.

State of the Art Technology
Utilizing our state-of-the-art Electronic Admission Review Management (E-ARM™) software, our seasoned RN Admission Review Screeners, using the most up to date, industry accepted evidence based screening criteria; provide your facility with the flexibility of just-in-time coverage.

Rapid Implementation
Proven Healthcare Solution's comprehensive turn-key approach allows for rapid implementation at your site.

Ongoing Reporting
Operational reporting on an ongoing basis allows us to provide your site with operational metrics and identify opportunities for PHS to implement site-specific provider and staff education.