At SV Assistance, case management is a cornerstone of our service. Our workflow begins with a thorough medical review and risk assessment to ensure that each patient receives the most appropriate and cost-effective care. We carefully select our healthcare partners based on their proximity, expertise, cost efficiency, and current utilization rates, ensuring patients are matched with the best providers and facilities.
Claims Handling and Cost Containment
Our Case Management Workflow
Medical Review & Risk Assessment: We conduct a comprehensive evaluation of the patient’s condition and medical history to assess risks and determine the most suitable care plan.
Provider Selection: Patients are referred to service providers and facilities that meet our stringent criteria, ensuring high standards of care. Selection is based on factors such as expertise, proximity, cost-effectiveness, and utilization rates.
Pre-Authorization for Treatment: We authorize essential medical treatments, ensuring that patients receive timely and necessary care without delays.
End-to-End Monitoring: Throughout the care process, our dedicated team remains in constant contact with both patients and insurers, ensuring transparent communication and smooth coordination of all medical services.
Coordination & Oversight of Medical Care
Our healthcare professionals oversee every aspect of the medical journey, including:
Hospital Admissions Coordination: Streamlining the admission process for a seamless transition into care.
Appointment Scheduling (Pre- and Post-Operative): Arranging and managing medical appointments before and after surgical procedures.
Monitoring of Treatment Plans: Ongoing evaluation of the patient’s treatment plan to ensure optimal care and outcomes.
Safe Discharge Planning: Coordinating safe and efficient discharge from medical facilities, ensuring continuity of care post-treatment.
Commitment to Quality & Cost Management
Each case is meticulously managed from start to finish, ensuring the proper utilization of services and the application of effective cost management techniques. Our goal is to balance high-quality care with cost efficiency, delivering value to both patients and insurers.
Just focus on your health, we'll handle the rest.
Each case is monitored from end to end ensuring proper utilization of services and effective cost management techniques have been applied.
Each case is monitored from end to end ensuring proper utilization of services and effective cost management techniques have been applied.
Each case is monitored from end to end ensuring proper utilization of services and effective cost management techniques have been applied.
Each case is monitored from end to end ensuring proper utilization of services and effective cost management techniques have been applied.
Each case is monitored from end to end ensuring proper utilization of services and effective cost management techniques have been applied.
Each case is monitored from end to end ensuring proper utilization of services and effective cost management techniques have been applied.
Each case is monitored from end to end ensuring proper utilization of services and effective cost management techniques have been applied.
Each case is monitored from end to end ensuring proper utilization of services and effective cost management techniques have been applied.
Cost Containment
SV Assistance Cost Containment provides a comprehensive solution for clients, verifying that charges billed are appropriate for the care provided. This unique approach begins with a thorough preliminary assessment of pre-paid claims by our experienced team.
- Preliminary Prescreen Review
A free high level prescreen analysis is performed on each prepayment claim to determine if appropriate for review.
- Out-of-Network Negotiations
Our experienced team uses reasonable and customary rates, benchmarking and historical experience to negotiate discounts on out-of-network charges.
- Comprehensive Bill Audit
A detailed line-by-line review that checks for medical bill errors such as unbundling charges, erroneous charges, inflated charges or coding discrepancies. Bill Audit options are available for both in and out of network claims.
Claims handling
Through SV Assistance comprehensive claims handling service we undertake the claims management from our clients. From negotiated settlements, bill adjustment, claims repricing and adjudication we provide end to end claims management.
