Qualis Health takes a patient-centered approach that honors each individual's culture, social context and values—and empowers patients to play an active role in making decisions about their own care. When healthcare is oriented around the unique needs of the patient, it can lead to higher patient satisfaction and better clinical outcomes.
That's why we were honored with two Case In Point magazine Platinum Awards in the categories of "Medicaid Case Management Program" and "Utilization Management Program" in 2010 and were a finalist for our Behavioral Health Care Coordination Program in 2013 and for our Workers' Compensation Utilization Management Program in 2012.
We guide our clients to be responsible stewards of healthcare resources by avoiding overuse, misuse and underuse of health services. Utilization Management means ensuring that every dollar spent on patient care is a dollar well spent. At Qualis Health, we make this happen by combining evidence-based criteria, data analysis and high-quality reviews. For the past 40 years, we have used this customized approach to help providers and payers keep their costs down while maintaining the highest quality of care possible for their patients.
Qualis Health provides web-based utilization reviews and targeted review programs based on extensive data analysis. We focus on patient safety and cost containment, leveraging our deep experience with and knowledge of evidence-based protocols to deliver appropriate and optimized care. Our utilization management best practices assure that patients receive the right care, in the right setting, at the right time.
Our case managers guide injured and ill patients as they navigate a complex healthcare system to obtain high-quality, patient-centered, cost-effective care. Care coordination is a systematic approach that includes careful assessment of an ill or injured person's unique healthcare needs, individualized care planning, removal of barriers to the receipt of appropriate medical and social services, and continuous monitoring to assure the best possible outcomes.