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Utilization Review/Management

For more than 30 years, HSAG has been performing utilization review of health services to ensure that patients receive optimal medical care that is medically necessary and delivered in the appropriate setting. Utilization review may be performed before, during, or after the provision of health care services, and includes precertification as well as concurrent and retrospective case review. HSAG has extensive utilization management experience, having reviewed more than 300,000 medical and surgical cases for medical necessity, appropriate level of care, and coding accuracy.

Case Management

HSAG provides case management/disease management services for individuals with complex medical needs. Our staff includes board-certified physicians, registered nurses, certified case managers, and nationally recognized experts in health care management. HSAG also contracts with more than 150 multi-specialty, board-certified physician advisors who assess patients’ medical conditions to determine medical necessity, appropriateness of treatment plans, and whether the quality of delivered care meets evidence-based community standards.

Critical Access Hospitals: Medication Safety Initiative

Health Services Advisory Group, Inc. (HSAG) has been contracted with the Florida Department of Health, Office of Rural Health, to conduct a patient safety initiative with a focus on medication safety for Critical Access Hospitals (CAHs) since 2003. In addition, as the Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Arizona, California, Florida, Ohio, and the U.S. Virgin Islands, HSAG offers technical assistance to Medicare providers on the Coordination of Care: Medication Safety initiative which focuses on reducing hospital readmissions and admissions and reducing the prevalence of Adverse Drug Events (ADEs) in Medicare beneficiaries.

Special Studies

Past Projects