August 21, 2020
Re: Testimonial for Services of Streamline Solutions Consulting, Inc.
The Sentara Revenue Cycle engaged the services of Streamline Solutions Consulting, Inc., specifically Dr. John Zelem, for an independent review of the Utilization Review processes for Sentara Healthcare. I have been acquainted with Dr. Zelem since the beginning of our business relationship in 2011 with Optum in his prior role as Regional Vice President of Provider Relations and Education.
In this time, I have come to value his experience, professionalism, and wealth of knowledge in the development of best practice programs related to utilization review, physician documentation, and regulatory compliance. We have built a trusting and collaborative relationship over the years which made the selection of John for our project an obvious choice.
The scope of the project included a very comprehensive review of our Utilization Review processes, the Physician Advisor program, the roles and working knowledge of other Sentara physician and non-physician leaders in the review process (Case Management, Clinical Documentation Improvement, Utilization Review, Chief Medical Officer, etc.), policies, opportunities, and outcomes.
The goal of the engagement was to make recommendations for an integrated, collaborative, unified team approach for a what came to be known as a “Utilization Management 360” approach enveloping all intra-operational entities involved decision support for documentation and billing compliance. This was a very comprehensive project that required extensive data reviews, interviews, and best practice research. At the conclusion of the project, John formulated very well thought out recommendations for our system delivered in a thorough executive report.
If you have further questions, I would be happy to assist you.
Karen A. Pelham, MSN, RNd
Director, Hospital Clinical Revenue Cycle