The Perfect Partner
Experienced Experts. Exceptional Service and Results.
With 50 years of managed care experience, you can be confident that MP CareSolutions understands that utilization management is a difficult balancing act between patient care, medical costs, and regulatory requirements. More importantly, we have mastered the “how to”. With timeliness, compliance, and efficiency at the forefront, we blend our knowledge with an understanding of your needs to develop and execute UM programs that are just right for your organization. As your dedicated partner, we can expertly support your organization in optimizing utilization management. In fact, Monroe Plan for Medical Care was named A Top UM Provider by Health Care Business Review magazine.
Let Our Expertise Drive Your Success.
100% Compliant with State regulations with no audit findings or citations.
RN Chart Audit Scores at 99% or greater using InterQual Criteria
100% Customer Satisfaction consistently meeting all established service level agreements
100% Inter-Rater Reliability Score
Physician Satisfaction is consistently 95% or higher
A Comprehensive Approach to Utilization Management
Medical care is increasingly complicated. The explosion of technology and home-based services along with consumer-directed information has created new, difficult to manage treatment requests that can increase costs and compromise care. Our experienced clinical review staff expertly handles new UM challenges, as well as the more traditional requests.
The Fundamentals
MP CareSolutions services Medicaid, Medicare, Accountable Care Organizations, special-needs plans, Patient-Centered Medical Homes, and other models of care delivery.
Our team reviews pre-service, concurrent, and post-service determinations in all service categories including medical, mental health, chemical dependency, and personal care.
Our process starts with implementing standardized procedures that ensure regulatory compliance, but we don’t stop there.
The MP CareSolutions Difference
- Bring extensive experience supporting large health plans and have the unique benefit of having operated a health plan
- Consistently use national, best-practice, evidence-based criteria for approval or denial of services
- Collaborate with our clients to ensure the best care while protecting resources
- Skillfully analyze utilization and cost data to improve processes and contain costs
- Proactively identify complex cases for care coordination and develop custom, cost effective care plans
- Leverage our NCQA Accreditation and Utilization Review Agent designation to benefit the patient and our customers
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Testimonials
At MP CareSolutions, our goal is to not just to satisfy our customers but to consistently exceed their expectations.
An important measure of customer satisfaction is customer loyalty. Our customer relationships span years and even decades. Our customers tell us their satisfied by continuing to allow us the privilege of serving them.
We bring a unique depth and breadth of experience to solving our customer’s problems, but we start by listening to what our customers have to say… their experiences, their challenges, their needs. Then we set about designing custom solutions that drive desired results. But don’t just take our word for it, read on to hear what some of our more than satisfied customers have to say …
“Exceptional Service from Utilization Management Experts”
MP Care Solutions, a Monroe Plan Company, has been providing Utilization Management Services to Amida Care for 7 years. From the onset of our partnership, it was clear that Monroe Plan’s team had the depth and breadth of experience with both utilization management and our specific population that could help streamline our processes and strengthen our regulatory compliance. Since engaging Monroe Plan, the timeliness and quality of reviews has been greatly improved. Monroe Plan is the perfect partner for us…a knowledgeable, collaborative, and cost-effective extension of our team!