UHC signs strategic partnership agreement with EHR

The University HealthSystem Consortium (UHC) and Executive Health Resources, Inc. (EHR) today announced the signing of a strategic partnership that will make EHR's expert Physician Advisor solutions available to all UHC members.

With this agreement, UHC's 107 academic medical centers and 220 affiliate hospitals can leverage EHR's comprehensive suite of solutions, which includes Concurrent Medicare Medical Necessity Compliance, Medicaid Medical Necessity Compliance, Retrospective Governmental Payor Appeals Solutions (including Comprehensive RAC, MAC, MIC, and QIO denial management), Managed Care/Commercial Payor Appeals, and Expert Advisory Services.

In addition, UHC and EHR will collaborate in analyzing hospital member-level data to identify specific areas for improvement and develop customized plans for concurrent medical necessity compliance and denials management services at hospital facilities. Once this work is complete, EHR can provide a comprehensive, on-site implementation program to educate the member's case management staff on using EHR processes and services.

UHC members can also benefit from EHR's ongoing compliance warranty program, which provides protection beyond the initial concurrent medical necessity review and certification. Finally, all UHC members can have complimentary access to exclusive, ongoing educational programming provided by EHR to help them stay abreast of the latest compliance news, strategies, regulatory updates, and guidance on current government auditing initiatives and other industry topics.

"In today's environment of increasing regulatory scrutiny, it is critical that hospitals mitigate risk exposure by implementing proactive measures to ensure compliance 100% of the time," explained Robert R. Corrato, MD, MBA, president and chief executive officer, EHR. "Through this strategic partnership, UHC is demonstrating its commitment to its members to help them in overcoming this difficult challenge. We are honored to work with such a prestigious health care organization."

To date, EHR's Physician Advisors have successfully performed more than 1.2 million medical necessity reviews, conducted hundreds of audits at client hospital facilities, and successfully identified and reversed thousands of RAC medical necessity denials at all levels of appeal. EHR's depth and breadth of experience was a contributing factor in its selection as UHC's preferred partner.

"This strategic partnership with EHR will offer UHC members not only specialized pricing but also services that include customized improvement insights. In essence, members will receive the added benefit of a specific plan for concurrent medical necessity compliance and denials management," said Tom Robertson, vice president, Business Strategies and Tactics, UHC.