Utilization Review

TREATMENT PLAN REVIEW/PRECERTIFICATION

Our treatment plan review services enable a proactive approach to managing the ongoing health care of the injured person. Services span physical therapy, chiropractic care and inpatient hospitalizations.

  • Determine medical necessity and appropriateness of all physical therapy and chiropractic treatment plans through peer review
  • Identify treatment considered excessive or experimental
  • Reduce medical costs by managing length of treatment
  • Detect potentially high-cost cases at an earlier stage

PROFESSIONAL REVIEW

Our Professional Review services assemble key data for effective case planning and resolution. The analysis is put together by our staff of Registered Nurses and Vocational Rehabilitation Specialists. Our staff perform reviews of documented information and construct in-depth analyses created to your exact specifications. They also provide defensible conclusions for use in litigation.

  • File Review
  • Medical Record Review
  • Life Care Plan
  • Expert Testimony
  • Litigation Support

PEER REVIEW

Peer Review provides a second opinion regarding the necessity and appropriateness of ongoing and/or prior medical treatment. Experienced staff members work with Board-Certified physicians, chiropractors and physical therapists to provide written opinions, depositions or expert witness testimony on a wide range of specialties.

  • Verify causal relationship
  • Identify unrelated treatment resulting in cost savings
  • Identify experimental treatment
  • Recommend reasonable and medically necessary care
  • Assist with resolution of litigated claims