AGS Health's Utilization Management (UM) services assist healthcare organizations in delivering appropriate, efficient, and cost-effective medical care by evaluating the necessity and efficiency of services and procedures through prospective, concurrent, and retrospective reviews. Their program ensures patient care aligns with current medical standards and optimizes resource allocation. Utilizing MCG and InterQual criteria, AGS Health confirms that cases meet established guidelines and determines the appropriate length of stay. They maintain clear communication with payers and internal teams, identify and mitigate potential risks such as overutilization, and analyze medical necessity denials to address root causes.