Utilization Review

Utilization Review


Through our conglomeration of work with the major insurance carriers including but not limited to: Blue Cross, Blue Shield, Aetna, Cigna, American Health Holdings, UMR, UBH(UHC), and Union Policies such as Teamsters, we have established relationships with the nurses, therapists, and doctors or "Care Managers" who authorize days of stay for a facility or Program that are employed by the insurance carriers.


With our relationship advantages, as well as our extensive expertise, we are able to provide our clients with much longer stays for their patients, while helping their clinical and medical departments document information in the form of best practices, to guarantee reimbursement.

By contracting with us for your Utilization Review Services, our clients save an average of 3%-6% a month, on reimbursements from the insurance carriers paid to their billing company, as a fee for completing the facility/program Utilization Reviews. 

Calendar Follow Up

Utilization Review assessments will be followed on a shared spreadsheet with all necessary facility and Revive Enterprises staff, that will ensure your patients are being authorized, and there will be no uncovered days of service.

DTX/RTC/PHP/IOP

Utilization Review Case Study

 *We began working with a program in 2020 that was originally 14 beds inpatient(DTX/RTC) and 20 beds outpatient (PHP/IOP) MH/SA.


*Through our Utilization Review Services over a 12 month period, this program was able to expand from 14 DTX/RTC beds, to 36 DT X/RTC beds, as well as 20 to 40 PHP/IOP outpatient beds.


*This facility is currently receiving nearly a 280% increase in annual revenue flow.


*This facility concluded that their average inpatient DTX stay had increased by 2+ days, their average RTC stay had increased by 7-14+ days and their outpatient stays anywhere between 15-30+ additional authorized units.

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