JSON twin: https://www.healthaidb.com/software/ags-utilization-review.json
AGS Health
AGS Utilization Review is AGS Health's utilization management service offering prospective, concurrent and retrospective reviews to validate medical necessity, determine appropriate length of stay, and reduce denials using evidence-based criteria.
A vendor-delivered utilization management program that applies MCG and InterQual criteria to perform prospective, concurrent, and retrospective utilization reviews; communicates with payers and internal teams; extends inpatient authorizations; identifies overutilization and denial root causes; and integrates with clinical documentation and denial-appeal workflows to optimize care appropriateness and revenue recovery.
yes
2011
P0058
2025-09-07
commercial/proprietary
contact vendor for pricing, custom engagement and service-based quotes
enterprise_quote
product
1.0
{
"company_name": "AGS Health",
"company_url": "https://www.agshealth.com",
"company_offices": [
"United States",
"India",
"Philippines",
"Mexico"
],
"company_founding": "2011",
"product_url": "https://www.agshealth.com/services/him-and-clinical-services/clinical-administrative-services/utilization-management-services/",
"categories": [
"utilization review",
"case management",
"clinical administrative services",
"health information management",
"prior authorization"
],
"market_segment": [
"enterprise",
"smb"
],
"links": [
"https://www.agshealth.com/services/him-and-clinical-services/clinical-administrative-services/utilization-management-services/",
"https://www.agshealth.com/",
"https://www.agshealth.com/contact-us/",
"https://www.agshealth.com/services/him-and-clinical-services/clinical-administrative-services/",
"https://www.agshealth.com/ai-platform/",
"https://elion.health/products/ags-utilization-review",
"https://www.linkedin.com/company/ags-health/",
"https://www.crunchbase.com/organization/ags-health",
"https://www.agshealth.com/privacy-policy/",
"https://www.agshealth.com/terms-and-conditions/"
],
"summary": "AGS Utilization Review is AGS Health's utilization management service offering prospective, concurrent and retrospective reviews to validate medical necessity, determine appropriate length of stay, and reduce denials using evidence-based criteria.",
"description": "A vendor-delivered utilization management program that applies MCG and InterQual criteria to perform prospective, concurrent, and retrospective utilization reviews; communicates with payers and internal teams; extends inpatient authorizations; identifies overutilization and denial root causes; and integrates with clinical documentation and denial-appeal workflows to optimize care appropriateness and revenue recovery.",
"target_users": [
"hospital administrators",
"health system leaders",
"utilization management nurses",
"case managers",
"physicians/clinical reviewers",
"revenue cycle teams",
"health information management (HIM) teams",
"payers (integration/coordination)"
],
"specialties": [
"inpatient medicine",
"acute care/hospital",
"ambulatory care",
"case management",
"behavioral health",
"post-acute care"
],
"regions_available": [
"United States"
],
"languages_supported": [
"English"
],
"pricing_model": "enterprise_quote",
"pricing_details": "contact vendor for pricing, custom engagement and service-based quotes",
"license": "commercial/proprietary",
"deployment_model": [
"SaaS",
"managed_services",
"professional_services"
],
"os_platforms": [
"Web"
],
"features": [
"concurrent utilization reviews",
"retrospective utilization reviews",
"prospective reviews/prior authorization support",
"extend inpatient authorizations for continued stays",
"medical necessity chart reviews per payer contracts",
"recommendation of alternate care options",
"validation to MCG and InterQual criteria",
"payer communication and coordination",
"analysis of medical necessity denials",
"root-cause remediation with CDI and denials teams",
"optimize level of care and length of stay",
"reporting and analytics for UM outcomes",
"collaboration with physicians and clinical teams"
],
"optional_modules": [
"clinical prior authorization services",
"clinical documentation integrity (CDI)",
"clinical denials and appeals",
"physician advisory services"
],
"integrations": [
"MCG (Milliman) criteria",
"InterQual (Change Healthcare) criteria",
"AGS AI Platform - Clinical NLP APIs"
],
"data_standards": [],
"api_available": "yes",
"system_requirements": "",
"compliance": [
"HIPAA",
"Cloud Security Alliance (CSA) best practices"
],
"certifications": [],
"security_features": [
"encryption (in transit and at rest)",
"role-based access control (RBAC)",
"single sign-on / SAML",
"audit logging",
"two-factor authentication (2FA)"
],
"privacy_features": [
"BAA available",
"consent and PHI handling practices",
"data minimization practices"
],
"data_residency": "",
"customers": [
"Aegis Sciences",
"Vanderbilt University Medical Center (VUMC)",
"ApolloMD",
"Auburn Community Hospital",
"TPMG",
"Banner Health",
"Richmond University Medical Center",
"SCP Health"
],
"user_reviews": [
"Good company, good benefits, company location is convenient, people are really nice to work with, there are tons of training provided, and good leadership.",
"Less salary and no night shift allowance.",
"Decent salary, less pressure, work life balance is there."
],
"ratings": [
"KLAS — Services overall performance: 85.6 (Sep 2024 - Sep 2025)",
"KLAS — Software overall score: 90.6 (Sep 2024 - Sep 2025)",
"Glassdoor — AGS Health employer rating: 3.5/5 (employee-submitted)"
],
"support_channels": [
"email",
"phone",
"webinars",
"request a demo / sales contact"
],
"training_options": [
"documentation (whitepapers, case studies)",
"webinars",
"live_online (webinars/videos)",
"onsite (customer engagements / implementations)",
"CEU credits through AAPC partnership"
],
"release_year": "",
"integration_partners": [
"EZDI (an AGS Health company / acquired technology)",
"AHIMA",
"AAPC",
"KLAS",
"MGMA",
"HFMA"
],
"id": "P0058",
"slug": "ags-utilization-review",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/ags-utilization-review.json"
}
}