Utilization management
Right Care. Right Place. Right Time. Right Results.
what we do
Telligen delivers comprehensive utilization management solutions that ensure members receive the right care, in the right setting, at the right time—while reducing administrative burden and optimizing healthcare resources.
We deliver URAC-accredited utilization management with FHIR-enabled technology for seamless EHR integration. Drawing on extensive nationwide experience with state Medicaid and commercial clients, our dedicated Center of Excellence ensures consistent best practices, while our Blue Ribbon Program rewards high-performing providers with streamlined authorizations.
our approach
Telligen’s modern, holistic approach integrates:
Clinical Excellence: Board-certified physicians and specialized healthcare professionals applying evidence-based criteria
Technology Innovation: AI-augmented automation delivering real-time authorization decisions
Holistic Integration: Seamless coordination of physical and behavioral health assessments
“You are the quickest and best submission process and I believe the industry standard.”
Contact a State Medicaid Solutions Expert Today!
Comprehensive um services
- Prior Authorization Reviews
- Medical Necessity Determinations
- Concurrent & Retrospective Reviews
- Quality of Care Assessments
- Fraud, Waste & Abuse Detection
- Provider Education & Support
state solutions
assessments
care management
quality & performance improvement
quality measurement & reporting
