Ophthalmologic Utilization Management
Expert Eyes on Your Side
By the year 2030, an estimated 72 million U.S. citizens will be 65 or older. The increase in the aging population will likely bring a rise in chronic ocular conditions – which will add to burgeoning ophthalmological costs.
With more than 30 years of experience in ocular health management, iCare Health Solutions offers your organization access to eye care expertise to reduce your ocular medical and surgical spending. Our medical review team includes sub-specialized ophthalmologists who are fellowship-trained as cornea, cataract, and retinal specialists. Our team aims to ensure members receive the proper levels of care at the right time and in the most appropriate settings.
iCare’s utilization management service leverages our ocular expertise, proprietary technology, and highly personalized service to:
- Apply proper ocular clinical utilization benchmarks
- Prevent duplication of services and curtail overutilization
- Monitor for appropriate adherence to medically necessary criteria
- Development and implementation of coverage criteria
- Facilitate redirection of services to the most appropriate settings
- Promote best practices in prevention and treatment
Helping You Navigate an Ever-Changing Ocular Health Landscape
The ophthalmology field is rapidly changing. iCare helps health care partners in the development and implementation of coverage criteria for emerging technologies and ophthalmologic procedures. Additionally, our utilization management team continually monitors for changes in medically necessary criteria as well as regulatory changes on local and national levels, and can provide consultation on how changes might affect stakeholders.
Utilization Management Focused on Your Success
iCare aligns with your organization to support your goals and works with you to deliver expectational experiences for all stakeholders.
COST CONTROL
Reduce eye medical and surgical costs and curtails overutilization.
REGULATORY COMPLIANCE
Ensure compliance with local and national UM regulatory statutes.
NETWORK RETENTION
Improve the provider experience, thereby promoting network retention.
MEMBER SATISFACTION
Prompt determinations result in satisfied members who receive timely and appropriate care.
RESOURCE ALLOCATION
Delegate prior authorization to us and refocus your assets with confidence.
See How Much You Can Save on Your Ophthalmologic Spending
Because we only focus on ocular health, our expertise in this space uniquely positions us to identify savings opportunities that other vendors often overlook – leading to significant savings.
Download our utilization management brochure
Find out how much you can save. To get an extensive review of your ophthalmology claims data, contact iCare Health Solutions by sending us a message.
