UR Setup at Your Hospital

[FutureRNArk]

I was wondering how your UR department was set up at other hospitals. In our hospital, we have a team of five RN's who do the Milliman reviews for all inpatients and OBS. Then we have 2 payor specialists (that's my position) who interact with the insurance companies faxing clinical information or doing telephone reviews for auths. We just started using Milliman at the first of the year (we used InterQual before) and they want us to begin only sending the MCG reviews to insurance companies as our clinical review. Does anyone else's hospital do this and is it successful? We are worried that it won't be enough for most of our payers, and additionally, that the reviews are usually not completed within 24hrs of admission and so we wouldn't have anything to send. I'm just wondering how your hospitals work this side of the UR piece.