Making sure care is necessary to prevent overpaying
At EHBA, we provide Utilization Management which is a review of the medical necessity, appropriateness and efficiency of the use of healthcare services under the provisions of the health benefits plan.
At EHBA Our Utilization Management professionals work with members before they receive care and while they receive care to ensure the most appropriate treatments are given. Our nurses, supported by a full panel of physician specialists, review all inpatient and outpatient services received to:
ensure doctor orders are carried out in an efficient and accurate manner, identify questionable medications or procedures, plan ahead and monitor the member’s progress. By working closely with healthcare providers, we give members information and options that can reduce hospital stays and speed recovery.