Medical Management
Utilization Management
The staff in the Utilization Management Department at PSW are trained and experience in many aspects of health insurance. They are available to answer questions regarding benefit coverage, Medicare regulations and authorization requirements daily from 8:00AM to 4:30PM.
The nursing staff is experienced in care management, Medicare regulations and case management. They can assist with resource information, direct admission to skilled nursing facilities and discharge planning. Nurses are available during regular office hours, they have voicemail for after hours messages and an on-call nurse for emergencies.
The UM/QI Committee is responsible for the oversight of both the Utilization Management and Quality Improvement programs. The committee meets on a monthly basis. Participation is open for PSW physicians.
MM/QI Committee
Mariella Cummings, CEO
Michael Herring, MD, Medical Director, Chair
David Fairbrook, MD, Assistant Medical Director
Lee Antles, MD
Darien Heap, MD
Ryan Johnson, DO
Robert Marlan, MD
Quinton Nguyen, MD
Beverly Roder, RN, CCM, MM/QI Manager
Shane Son, MD
Todd Woltman, MD
Providers
- Claims
- Quality Improvement
- Medical Management
- Links
- Physician Meetings
- Login: Board Member Portal