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- Pre-admission review based on accepted medical practices and standards of individual community
- Medical necessity verification for a continued stay
- Patient care assessment to determine alternatives for treatment
- Claim review to ensure appropriate care was given and accuracy of billed charges
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- Identify catastrophic illness or injury
- Assist employees in identifying additional resources that may be available
- Offer AHG’s national “Centers of Excellence” for referrals on complex cases
- Monitor improved standards of care at each hospital
- Review and negotiate on high dollar cases
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