The low-cost, high touch way to scale your medical management programs
Lateral combines 20 years of healthcare expertise with frontier technology to provide low-cost medical management services
Our Services
Our team has lived provider and payer operations for 20 years.
One team handles everything, so you can scale operations without adding overhead
or juggling vendors.
Enabled by our technology partnership with Anterior, we deliver streamlined
medical reviews at industry-leading rates.
We process volume
surges, launch new programs, and adapt to your changing business
needs—while keeping your costs predictable and competitive. You maintain control while we deliver high quality medical management programs that scale.
Utilization Management Services
Prior Authorization
Reviewing and approving requests for medical services, treatments, or medication before they are provided to ensure medical necessity and alignment with health plan policies.
Concurrent Review
Monitoring the care being delivered to a patient during an inpatient stay to ensure ongoing medical necessity and efficient use of resources.
Discharge Planning
Assisting patients in transitioning from inpatient care to home or another care setting by coordinating follow-up care, arranging necessary services, and preventing readmissions.
Retrospective Review
Evaluating the appropriateness and medical necessity of care after it has been delivered, often used for auditing or quality improvement.
Appeals Management
Handling member or provider appeals when prior authorization or claims are denied, ensuring adherence to policies and regulations.
Payment Integrity
Ensuring that claims are accurate, comply with contracts and policies, and are free from fraud, waste, and abuse through audits, overpayment recovery, and process improvements.
Case Management
Coordinating care for patients with complex medical needs to ensure they receive appropriate services and support, often including chronic disease management.
Disease Management
Providing structured care programs for patients with chronic conditions (e.g., diabetes, hypertension, COPD) to improve outcomes, reduce complications, and lower healthcare costs through education, self-management support, and regular monitoring.
Risk Management
Identifying members at higher risk for health issues to offer targeted interventions and preventive care.
Born in Colorado, but serving payers nationwide.
Our vision is to redefine utilization management by fostering innovation, collaboration,
and trust among payers, providers, and patients through the use of state-of-the-art
technology.
We are striving to remove the administrative burden and allow clinicians to
focus on what is most important: the patient. If that resonates with you, we'd
love to hear from you.
Open Positions
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Clinical Quality RN
Colorado
Clinical Operations
Apply Now