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Medical Management

Utilization Management (UM) and precertification are important concepts in the area of healthcare coordination, and in the services Medicus, A Health & Lifestyle Management Company offers to its members. UM is the process of managing the use of medical services so that a patient receives necessary, appropriate and high-quality care in a cost-effective manner. Precertification is a means of utilization management that requires a member to notify a medical management company to determine whether a proposed course of care or medical service is medically appropriate.

Medicus provides these services by working with healthcare providers, reviewing activities of a practice or facility and tracking quality indicators throughout the utilization management process.

Medicus' employees include full-time registered nurses with diverse clinical backgrounds, as well as courteous and professional support staff who offer their full attention to the concerns of providers, employers, and members. Medicus has an established reputation for excellent service, and continues to fine tune its procedures and protocols. Medicus uses state-of-the-art systems to review cases and identify potential quality issues. Activities are regularly reviewed by quality and utilization management committees, made up of physicians who are part of Berkshire Health Partners.

To contact Medicus please call 800-647-2500 or 610-372-8417.