Utilization Reviews

Comprehensive Utilization Review Services

Every state’s goals and initiatives are to promote placement in the least restrictive, least resource-intensive level of care necessary to meet individuals’ needs. With methods based on these principles, MAXIMUS delivers gold standard, evidence-based Utilization Review (UR) services for a variety of state programs and a diverse range of populations, age groups, and diagnoses. Our UR methodologies are tailored for each state to accommodate unique participation criteria, provider standards, and other measures important to oversight agencies.

Up to 75%

enhanced federal matching for qualifying utilization reviews

Comprehensive Utilization Review Services

Processes and systems recognized by CMS

Our customized electronic screening tool offers a substantial cost savings and efficiency measures for states and providers by enabling around-the-clock, data-driven utilization review decisions. Using our processes and systems, states have fast results in determining support needs and appropriate levels of care, and they have immediate access to monitor the quality of provider services and their treatment practices.

With our designation as a Quality Improvement Organization-like (QIO-like) Entity by the Centers for Medicare and Medicaid Services, states contracting with Ascend on UR activities receive enhanced federal matching incentives (up to 75%) for qualifying utilization review and quality of care initiatives.

QIO-like Entity

CMS designates Ascend a Quality Improvement Organization-like Entity

Processes and systems recognized by CMS