Transforming Utilization Management to Deliver $12.4M in Annualized Revenue

Full Case Study

27K Admissions

EMR EPIC

Academic Medical Center

86%

Accurate Patient

Status Prediction

9.2%

Reduction in
OBS rates

9%

Increase in Monthly
Patient Upgrades

The Challenge

Facing inefficiencies in their Utilization
Management (UM) processes, this health system
embarked on a transformative journey to
streamline workflows, improve accuracy, and
maximize revenue. Historically operating under a
dyad model, where case managers also handled
utilization reviews, the team struggled with
competing priorities, complex payer
requirements, and time-consuming manual
processes. Additional more common challenges
that they were looking to overcome.

Limited Staff & Resources

Restricted the number of case reviews possible.

Complex Payer Requirements

Ever-changing and varied rules caused delays and denials.

Poor Payer Communication

Resulted in incomplete patient stories and denied claims.

Inefficient Workflows

Time wasted on unnecessary reviews and difficulty compiling documentation for medical necessity.

We love IodineUM. You have great people and great products.

Absolutely amazing! The chart summary is off-the-charts amazing. It’s almost like I had a doctor dictate the note.

Key Outcomes

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Driving Outcomes with Operational Efficiency

Triad Model Success: Nurses now focus 100% on utilization reviews, eliminating competing priorities.
Faster Reviews: IodineUM reduced review times from 15-20 minutes to just 5-7 minutes per case.
Lower OBS Rates: Achieved a 9.2% reduction (from 13.3% to 11.7%) since going live in May 2023.

Revenue Growth

Boost Status Conversions: Realized a 9% monthly increase in patient status upgrades, unlocking additional reimbursement.
Capture Missed IPO Revenue: Identified and corrected IPO procedures, generating an estimated $800,000 annualized revenue.

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Substantial Financial Impact

Achieve $12.4M in Annualized Impact: Achieved with just a 50% priority review rate, revealing substantial opportunity for scale.

The Iodine Solution

Utilization Management

IodineUM helps UM teams get reimbursed for the right level of care.

Learn More

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