Medical Utilization Review

RUM allows you to optimize the health care your organization provides.

This program is fully functional for the team of professionals who perform the case management and medical review of the hospitalized patient.

RUM is a tool that provides effective and easy-to-use technological solutions. Collect patient information by processing the criteria that involve patient management and the effective review of the use of medical services. HCMS has developed the RUM system that integrates different technologies so that the professional can make correct and effective decisions for the management of the medical condition of their clients. The electronic information that RUM feeds on is managed by the same database of the different departments of your organization. The integration into the clinical care of the administrative and financial areas allows you to customize the services of your organization. The data transfer is completely secure and in an encrypted way through channels and channels that allow you to comply with the privacy requirements of the HIPAA law.

Save time and money

RUM will help you reduce time, unnecessary expenses and your exposure to economic losses through the administration of medical use with the help of technology. It also offers you different tools that will help you stay in line with the regulatory requirements.

RUM offers you:

Census of hospitalized patients
Census for medical plans
MU History
MU stay times
Calendar and reminders
Clinical activity management
Email and mobile text notifications
Referrals to Medical Consultant. And referred to other departments.
Calendar for closing records for audit
Reminder and follow-up of cases in appeals
Extraction of statistical data.

Reports for better administration

RUM has an intelligent system that allows you to access the statistical data and medical history of the institution immediately. Get in minutes and in real time, an overview or detail of the UM, as well as the time of use and the quality of care that your organization provides. RUM electronically integrates all the data of your organization and provides you with the statistics properly organized and in an easy to understand way. This unique program allows you to see in real time the reports, graphs and calculations of the use of hospital medical services as well as different profiles. RUM reduces operational costs by offering the most sophisticated user-friendly system. RUM makes employees more effective and efficient by reducing handling time per case and making reports. RUM synchronizes with the departments involved in the management and medical care. RUM simplifies the work and accelerates the conclusions to make sound decisions to optimize the quality of organizational care. With complete visibility, simple reading and easy analysis, look at the reports and metrics.

MU medical profile
MU hospital profile
Approvals and denials by medical plan
Cases closed and pending by medical plans
Audits and appeals
Days Approved vs. Days Denied
Most Denied Diagnostics

Average days of stays
MU reports and graphs
Reasons for denial in reports and graphs
Reports of economic losses by medical plan
Case Manager Profile
Average time report per case management