FAQs

Apollo medical review criteria are used in almost every state and Puerto Rico by: Health Plans, capitated medical groups, MSOs, provider networks, IPAs, behavioral health providers, medical school faculty, practice groups/plans, hospitals, PHOs, State and County Health Departments. Additional users include: Review organizations, specialty networks, indemnity carriers, third party administrators, consultants, law firms, VA hospitals, U.S. Military, Indian Health Services, and Licensing boards.

Yes. Our applications provide criteria and guidelines comparable to those of our competitors. However, our users tell us that Apollo applications are easier to use and offer faster access to the specific information they need. They are also more affordable.

Apollo criteria have been developed by and under the direction of Margaret D. Bischel, MD, FACP. Contributors to the development process include many health plans and other entities that use Apollo criteria. All Apollo criteria and guidelines are evidence-based and supported by extensive current references in the peer-reviewed literature.

We provide a 5-minute online tutorial that shows our users everything they need to know in order to take advantage of Apollo application features. Because our solutions are designed to be user-friendly and intuitive, technology-related questions or issues are rarely encountered. More in-depth onboarding and “train the trainer” is available, if needed.

Selection occurs from a pool of accredited carriers. When available, AHRQ, peer-reviewed medical literature, and other resources for authoritative review articles are incorporated. Similarly, national guidelines from specialty organizations are cited. In most cases, a link to the original resource is listed for quick access by the reviewer.

Comprehensive care or clinical guidelines are available for pediatric, medical, obstetrical, mental or behavioral healthcare. The focus of Apollo’s medical review criteria is coverage based on evidence-based medically necessary appropriate care.

Our applications contain a built-in mechanism that allows the user to ask a system or criteria-related question and receive a response within 24 hours or less. Clients do not have to work through a cumbersome ticket system to get the support they need.

Review criteria and guidelines are updated daily and made available on a real-time basis via the Apollo Managed Care web portal. Our clinical experts continuously scan Peer-reviewed literature for new information pertaining to Apollo criteria. We have also created a unique algorithm that provides notifications to our Apollo team when a client searches on an area or subject not currently addressed within one of our applications. When this occurs, the team will quickly move forward to capture the required data and incorporate the new guideline into the software.

Apollo guidelines are also subject to regularly-scheduled quarterly reviews, with ALL guidelines reviewed at least annually.

All Apollo applications operate within an advanced Microsoft .NET framework that facilitates rapid integration with existing Utilization Management and Care Management systems to further enhance your clinical decision-support strategies.