One of the factors that has the biggest impact on how well a patient does after treatment is how long the patient stays in treatment. Yet an ongoing challenge for many treatment centers is payer demands that a patient step down to a lower level of care more quickly than the clinical team thinks is appropriate.
Fortunately, Vista’s real-time patient monitoring research gives your UR team the data they need to justify medical necessity and argue persuasively for more days.
Enlightened Solutions, a holistically- and clinically-driven Partial Care (PHP) and IOP program in New Jersey, tracks the number of days they receive approval for by level of care. They found that Vista’s patient monitoring data allowed them to get an average of two more Partial Care days approved (an increase of 13%) than they had received the previous year:
Vista’s research helps your UR team get more days approved in two ways:
At the Start of Treatment: The detailed information patients provide on Vista’s intake questionnaire allows your UR team to answer the types of questions the payer representative needs to know in order to approve treatment at the highest level of care for the maximum number of days:
Throughout Treatment: Vista’s progress monitoring research alerts team members when patients are struggling with co-occurring disorders or suicidal thoughts. This data may allow the UR team to persuasively argue that a patient is not ready to step down to a lower level of care:
Getting more days approved is just one of the ways that Vista’s outcomes research helps your team help more patients recover, but it’s the one that will get your CFO most excited. I’ve yet to do an ROI analysis that didn’t show that Vista’s inexpensive outcomes research more than pays for itself. If you’d like to learn more, please watch a demo and set up a time to chat.
Joanna
