Quality Resource Management

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Phone. 937-641-3328

Director: Carol L. Wise, MS, RN, BC, CPHQ

Services Available

  • Concurrent review of all inpatient admissions from the quality, utilization management and risk management perspectives.
  • Communication of clinical information to third party payers for certification of patient stays.
  • Facilitation of medical necessity denial and appeals, both for commercial payers and Medicaid patients.
  • Coordination of hospital utilization management concerns with the Vice President of Medical Affairs, the Chief Finance Offices, attending physicians, residents and other health care team members.
  • Tracking and trending of identified quality, utilization and risk management concerns.
  • Coordination of information for third party payer scorecards.
  • Provision of data support for the clinical practice guideline teams.
  • Overall support for the JCAHO and other regulatory surveys.

 

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Upcoming Events

Voyage on the Parkway: a fun event for families with preschool aged children.

Child car seat safety check by certified technicians

Blue Ribbon Nite Gala to support the Child Advocacy Center of Warren County

View full event calendarView full event calendar

The Right Experts

Just right for all kids

Accreditations

The Children's Medical Center of Dayton Dayton Children's
The Right Care for the Right Reasons

One Children's Plaza - Dayton, Ohio - 45404-1815
937-641-3000
www.childrensdayton.org