About 30% of Specialists Are Not ‘Outlier Providers’ and Should Receive Relaxed Prior Authorization or Be Gold-Carded

About 30% of Specialists Are Not ‘Outlier Providers’ and Should Receive Relaxed Prior Authorization or Be Gold-Carded

SAN MATEO, Calif.–(BUSINESS WIRE)–Cave Consulting Group, Inc. (CCGroup) has determined that 30% of specialists should receive relaxed prior authorization and utilization management (PA/UM). At issue is that many health plans and other payers have yet-to-implement an evidence-based, clinical decision support system to gold card network specialists.

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