Quantum uses a set process developed to ensure success for both employers and employees utilizing our EAP. This process, the Quantum Review, includes Utilization Review and Case Management (UR/CM), and has been proven effective for 20 years in providing appropriate help to employees, while remaining cost-effective for employers.

• Telephone Access
• Pre-certification/Clinical Determination of Care
• Coordination with Third Party Administrator
• Assessment and Referral
• Concurrent Review
• Second Opinion Procedures (where required)
• Follow-up Review
• Large Case Management (when appropriate)
• Quality Assurance

Quantum's centralized diagnostic and referral functions include identification of the most clinically appropriate and cost-effective level of intervention for each individual situation. The UR/CM process monitors all phases of treatment, starting with the initial request for help. Case managers assess the necessity and appropriateness of treatment, develop a plan for providing and monitoring care, and approve provider treatment plans with internal protocols and criteria for clinical care.

The concurrent review protocol monitors treatment in terms of frequency, duration, and efficiency. As a result, alternative modalities of care can be developed and recommended as circumstances dictate. In cases of in-patient treatment, discharge planning provides for early identification of cost-effective alternatives, allowing better management of care transition from acute to follow-up. During after-care monitoring, the case manager assists the patient in making a complete transition from treatment to normal living in order to guard against relapse and inappropriate re-entry into treatment.

Overall, Quantum's integrated UR/CM model allows for better determination of the required depth of clinical services by tracking the level of care needed, while simultaneously monitoring projected outcomes and costs.

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