Clinical Services

Here you will find a brief synopsis of our services, click each underlined heading for a complete explanation

Our Specializations:

Do you have questions about our services?

Contact us at 1-888-909-RCMS(7267) or via our contact form.

 

 

UTILIZATION MANAGEMENT

 

RCMS has been certified by the State of TX as a Utilization Review Agent (URA)Our UM Program may be all-inclusive or focused on one or more areas of:

  • Prospective Reviews/Prior Authorizations
  • Concurrent Reviews/Continued Stay
  • Retrospective Reviews
  • Outpatient Services
  • Ancillary Services
  • Imaging and Diagnostic Services

 

 

 

CARE MANAGEMENT

 

RCMS offers care management services for children, the elderly, chronic conditions, high-risk pregnancies, and those who receive Government funded health insurance such as CHIPs, Medicaid and Medicare. Our CM Program may be all-inclusive or focused on one or more areas of:

  • Telephonic Care Management (TCM)
  • Field Based Care Management (FBCM)
  • Disease Care Management
  • Medication Reconciliation/Management
  • Denied Treatment Appeals

 

 

STAFF ENHANCEMENT SERVICES (SES)

 

RCMS' version of temporary services was specifically developed for how managed healthcare companies do business today.  SES is more cost-efficient and has staff available immediately upon request.  

 

 

 

 

 

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