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Clinical Services

Medicaid Review and Prior Authorization for Hospitals

AFMC’s Fort Smith office is  URAC Accredited in Health Utilization Management. Our clinical Services team, which consists of physicians and registered nurses, conducts more than 185,000 medical case reviews per year. These include prior authorizations and retrospective utilization reviews to ensure that all health care services reimbursed by our clients are provided in the most efficient manner and are medically necessary. Clinical Services reviews enable hospitals to deliver the highest quality of care while preventing fraud and abuse.

Services

Practice Review

AFMC’s Fort Smith office provides URAC-accredited Health Utilization Management reviews for public and private health plans to ensure all health care services reimbursed are provided in the most efficient manner and are medically necessary. Our Clinical Services staff enables providers to deliver the highest quality of care, while at the same time preventing fraud and abuse.

Appeals

Learn more about the Medicaid Fairness Act.

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Physician Reviewers

Earn extra income. Become a physician reviewer.

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