AMI's CHIROPRACTIC BENEFITS MANAGEMENT MODEL PUTS EVERYTHING IN PLACE

AMI’s unique and proprietary utilization management will provide cost savings without sacrificing provider relations and patient satisfaction.  Utilizing a system of outcome management, AMI creates a balance of cost savings and cost effectiveness of care, in a provider friendly system that is patient centered and outcomes driven.

The AMI’s ChiroOutcomes Management System (ACOMSsm) identifies the member’s condition classification and severity rating, so that the care provided is compared to specific criteria for that condition classification/severity rating; not a general “all in one” guideline.  The system then monitors outcome as a basis for determining if the member has reached maximum therapeutic benefit or if additional care is necessary; tracking both response to care and the natural course of recovery for the condition/severity rating.

As an example, a hypothetical 24-visit claim benefit/edit does not account for the member’s diagnosis, severity of condition or response to care.  While most treatment episodes will fall within the 24 visit guideline, there is no accountability for outcome and/or medical necessity of the treatment provided.  There is no way to identify if the first 12 visits achieved maximum therapeutic benefit and the next 12 visits were not medically necessary. 

Measurement through Mandatory Notification of a patient’s outcome, using industry accepted measurement tools with accepted appropriate clinical metrics, is a much more effective and objective barometer of provider performance, than a pre-determined number of visits or modalities…and much less controversial to both patient and doctor.