We design, develop and maintain managed care programs that integrate core services within Workers’ Compensation.
As a result, both patients and their employers realize superior claims outcomes.
Our managed care solutions provide proactive management of Workers’ Compensation cases. We fully integrate specialized managed care solutions with claims systems, delivering exceptional patient care while keeping claims costs low.
Peer Review – Our panel includes URAC-accredited IROs from a wide range of specialties. They provide expert assessments of both medical necessity and causal relatedness for proposed treatments. Additionally, the process identifies and prevents ineffective or unrelated treatments.
Compliance – Strict quality assurance ensures you’re in compliance with all state-mandated regulations, as well as URAC standards for Workers’ Compensation. Through ongoing education, we continually stay on top of trends and regulation changes.
Pre-Authorization Services – Using the latest technology, our experts review requests for treatment against nationally accepted, evidence-based guidelines. This results in faster reviews, a more rapid return to work and shorter waiting periods for authorizations.
Our comprehensive approach delivers efficiency and results at every step through the life of a claim:
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