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Talk More – Deny Less

October 2016 Blog, Health Management, The Business of Health Care Comments Off on Talk More – Deny Less

What defines an effective patient management vendor? Is it working in a delegated relationship and issuing denials of inpatient days? How about refusing to approve services that might be helpful in moving a patient out of the hospital to home? Maybe making adverse determinations without discussions with medical care providers?

At ProgenyHealth, we don’t believe that any of those things produce effective or sustainable relationships with providers. Instead, we promote proactive and consistent dialogue with our clients’ providers to anticipate clinical needs and prepare for the next level of care. Our nurses and physicians speak directly with the clinicians in the facilities to discuss the care being provided, barriers to patient progress, and anticipated discharge needs. They discuss the best approach to achieving a healthy outcome and, where possible, address discharge needs early. This proactive and consistent dialogue is one of the primary tenets of the ProgenyHealth medical management model. continue reading