196 Charmant Drive,
Suite 3
Ridgeland, MS 39157

Phone: 1(601) 366-3669
Toll-free: 1(800) 748-8773

info@hughes-assoc.com

Pre-Certification - On-line Precert Software Access

Hughes & Associates' pre-certification program is designed to monitor and evaluate the course of treatment rendered by all health personnel given a standard of desirable care. It is a process that looks at the following to determine if the treatment, as prescribed, is appropriate:

  • The medical necessity of treatment
  • The setting for the treatment
  • The types and intensity of resources to be used in the treatment
  • The time frame and duration of the treatment

The purpose of Hughes & Associates' pre-certification program is to monitor the delivery of medical services to insure that those services are performed at the appropriate level of care in a timely, effective, and cost-efficient manner.

    PRE-CERTIFICATION
  • Pre-admission Certification
  • Continued Length of Stay
  • Discharge Planning
  • Retrospective Review
  • Outpatient Surgery
  • Diagnostic Tests
  • Physical Therapy Review
  • Mental Health and Substance Abuse
  • High Risk Maternity and Neo-Natal
  • Home Care Services and DME
  • Notification of Long-Term and High Dollar Treatments
  • Cost Savings and Utilization Tracking Reports

The above services can be selected individually, separately grouped or bundled as a complete managed care cost-containment program.

PRE-CERTIFICATION FLOWCHART

precert

*By utilizing nationally accepted criteria and objective clinical experience, each case is analyzed for: 1. medical necessity of admission; 2. appropriate length of stay; 3. alternate treatment or setting; 4. discharge plan. **Cases requiring further review are referred to one of our staff Mds.