Staff Spotlight, Judi Churchward
Tell us about yourself!
My name is Judi Churchward, and I use she/her pronouns. My title is Utilization Reviewer, and I’ve been with Accanto Health (the parent company of The Emily Program and Veritas Collaborative) for five years. I live in a small Wisconsin town (731 people) and work remotely out of my home office. I attended college in the Twin Cities, Minnesota, and have a bachelor’s degree in Human Services.
What does a typical day look like for you at Accanto Health?
My day is filled with opportunities to advocate for our clients in higher levels of care (Inpatient, Residential, Partial Hospitalization, and Intensive Outpatient). As a Utilization Reviewer, we “paint a picture” of a client’s need for treatment or current treatment status. Using clinical information gathered from our providers (at intake or while in programming), I strive to provide the most direct and informative clinical information to the client’s insurance provider in order to obtain an initial authorization (for admit) or authorization for continued treatment. Whether I talk directly to an insurance reviewer, leave a voicemail, use a web portal, or send via fax, I provide information about the client’s progress and/or barriers, current treatment interventions, medication updates, medical needs, and vitals.
I regularly collaborate with many teams across Accanto Health. These teams provide information regarding a client’s admission, insurance eligibility, and authorization requirements, obtaining single case agreements or a financial waiver. I may communicate with the client’s facility’s front desk staff, site director, or providers who assist with questions. At times, I will need to address billing tickets for authorization-related issues.
What is something people might not know about the role of a Utilization Reviewer?
We are the “middle person.” On one side, we rely extensively on clinical notes entered by a client’s care team. On the other side, we are presenting clinical information to an insurance care advocate/manager, who needs to hear and agree the client meets their medical criteria for admission or continued stay. When there are denials, we schedule peer reviews with a member of the client’s care team and the client’s insurance. We may also work on appealing denials for continued stay or claims. We manage a client’s authorization needs through each level of care until the client is ready for outpatient services.
What motivates you to show up to work each day?
I’m part of such an amazing community of supporters here at Accanto Health. I can’t help but have an enormous sense of pride. Our clients are so courageous. As difficult as it may be, they choose their recovery in the moments they have strength, and their care team chooses their client’s recovery for them when it’s too tough to do so on their own. I have a great desire to do my part so that the choice of recovery is a little easier for clients.
What do you like to do when you’re not working?
Although I love spending time with my friend and furry co-worker, Skye (pictured with me), I also have a number of grandchildren in sports. My husband and I spend much of our free time in early spring and summer attending soccer, basketball, lacrosse, and volleyball games. We both love it. We know how quickly children grow, and we want to participate in their activities as much as possible. They are great athletes and part of another amazing generation. I’m a very fortunate grandparent.