Advantica Awarded NCQA Certification for Utilization Management

CLEARWATER, Fla.— Advantica, a leading ancillary benefits company, announced the successful renewal of its National Committee for Quality Assurance (NCQA) Certification in Utilization Management for eyecare services.

As an eyecare benefits administrator, Advantica employs utilization management strategies to deliver high-quality services to its health plan clients. The company’s proprietary set of clinical and billing guidelines are applied at every stage of the claims lifecycle through prior authorization, auto-adjudication of claims and manual reviews. These practices detect overbilling and/or unnecessary procedures and allow Advantica to intervene in cases when services are found to be inappropriate or excessive.

“It is our goal to provide clients and members with reduced costs, improved quality of care and an overall positive experience. NCQA’s renewal of our utilization management program certification is affirmation that we are achieving that goal,” noted Mark Sarno, OD, Advantica medical director.

NCQA’s Utilization Management Certification Program assesses key aspects of utilization management operations that focus on consumer protection and improvement in service to customers. NCQA is a private, non-profit organization dedicated to improving health care quality and it accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance.