Utilization Review Software and Training for IHS WRSU

WRSU needs a web-based software product that delivers evidence-based clinical criteria intended to assist Utilization Review staff apply objective, specific clinical criteria to ensure patients meet the CMS Conditions of Participation definition of medical necessity. The software will ensure objective, consistent, defensible decision-making to reduce financial and regulatory risk related to delivery of healthcare services in the appropriate level of care. The software will be utilized by the Utilization Review nurses, and available to all admitting providers at Whiteriver Indian Hospital. SEE ATTACHED SOW