Patient Navigator Program
Transforming Critical Operations & Protecting Hospital Revenue
The Patient Navigator Program is a specialized clinical integration service designed to bridge the gap between emergency care and appropriate inpatient utilization. Built for modern hospital systems and rural facilities, our program ensures that every patient is placed in the correct "stay-type" from the moment they enter the facility.
By deploying expert Remote Utilization Review (UR) specialists, we provide real-time clinical decision support using industry-standard medical necessity criteria. We don’t just track data; we integrate with your frontline team. Our Navigators conduct daily morning and shift-change check-ins with your Physicians and Charge Nurses to ensure seamless communication.
Up Front Qualifications:
We qualify admissions before the claim is generated, aligning your documentation with payer standards to prevent technical denials.
Staff Advocacy:
We offload the administrative burden of UR from bedside clinicians, allowing them to focus entirely on patient care.
CDI Recommendations:
Our specialists provide specific Clinical Documentation Improvement (CDI) recommendations to ensure the medical record accurately reflects patient acuity.
Proven ROI:
The program is designed to be self-sustaining, typically paying for itself with just one additional qualified admission per month.