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ABS Managed Care

Apollo Medical Review Criteria

The Care Management Department of ABS utilizes Apollo Medical Review Criteria Care Criteria® for
making clinical decisions. The criteria are evidence based and utilized as a guideline. The
criteria assist with managing care processes and resources in a way that fosters evidence-based
practice and ensures patient safety while controlling medically unnecessary care.

Apollo Medical Review Criteria Care Planning Criteria helps ABS evaluate the appropriateness of
care-related interventions including diagnostic testing and procedures.

Apollo Medical Review Criteria Level of Care Criteria aid in recommending the right level of
clinical care or setting for patients—from acute through outpatient treatment.

Using information found in the medical record or supplied by healthcare providers, the ABS reviewer
determines whether a patient’s clinical status matches the criteria for a specific intervention or
placement at a specific level of care. When there isn’t a match, a reviewer or physician advisor
can work with the attending physician to decide on an appropriate course of action.

Specific Apollo Medical Review Criteria is available upon request. If you would like to review or
discuss the Apollo Medical Review Criteria, please contact Barbara Kelly, RN, BS, CCM the ABS
Manager of phone: 586-693-1216 or via email at bkelly@abs-tpa.com.