Utilization Management begins with pre-certification requirements that are designed to ensure you receive the right care at the right time. After the pre-certification process is complete, if you or a family member undergoes treatment in a hospital or similar setting, our Utilization Management professionals work with you to help you receive the most appropriate treatment.
Our nurses, supported by a full panel of physician specialists, review the inpatient and outpatient services you receive. We identify questionable medications or procedures and look for criteria that indicate where other treatments are available.
Active involvement by Prairie States' clinicians during your treatment is designed to give you peace of mind. By working closely with your healthcare providers, we’ll provide you with information and options that can reduce hospital stays and speed recovery.
Contact us for more information about Utilization Management and log in to your My Prairie Online Account for more information about pre-certification requirements.