4-Square Consulting, LLC                                       1-866-429-8747
4 -SQUARE MANAGEMENT:

Mission Statement:

“Credentialed clinical staff using proven medical criteria, grounded in evidenced based medical practice standards, ensuring a consistent quality of care to the patient and a maximization of revenues for our client facilities is the cornerstone of 4- Square Consulting’s Utilization Management and Review Program.”

4- Square Consulting’s utilization management and review program centers on our experienced clinical staff’s usage of proven medical criteria grounded in evidence-based medical practice standards ensuring a consistent quality of care for clients and a standardization of healthcare service delivery; both of which ultimately serve to maximize cash flow and increase revenues to facilities we service, while simultaneously reducing costs and improving patient outcomes.

Our clinical staff provides a complete array of medical-legal services related to medical record analysis and reviews; for Attorneys (Plaintiff / Defense), Adjusters,  or Physicians.

Our utilization management and review services span the full scope of utilization-related activities, including:

  
  • Prior Authorization & Post Admission Authorization
  • Verification of Benefits
  • Concurrent Review for both inpatient and outpatient courses of treatment
  • Retrospective Review- Including Medical Bill Audits
  • Appeals Review
  • Peer Review
  • Risk Management Services
  • Program Implementation- IOP / PHP
  • Medical Records Review and Analysis
  • Medical-Legal Consulting Services

 Our clinical review personnel and Medical Director work directly in conjunction with our client staff to identify opportunities for improvement in the quality of patient care via changes to the existing utilization management and review process based on trend analysis or medical “spot” audits performed by 4- Square Consulting.

4- Square Consulting performs utilization management and review services using state of the art proprietary utilization review/case management software. We recognize the clinical urgency of utilization management and review decisions – ensuring that utilization activities and decisions are made in the time frame, manner and criteria set forth by applicable laws, plan policies and contractual client mandates. 

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