Managed Care Services
We design, develop and maintain managed care programs that integrate core services within your Workers’ Compensation program. As a result, both injured workers and their employers realize superior claims outcomes.
Industry-Specific Solutions
Athens Managed Care, Inc. provides businesses with specialized managed care solutions that deliver
superior patient care and results in lower overall claims costs:
- Experienced Managed Care Team
- Fully Integrated Managed Care Approach
- Complete Transparency with Bill Review and
Case Management Fees - Aggressive Claims Management Strategies
- Client Specific Criteria Development
- Highly Efficient Referral Process
- Highest Level of Timeliness, Communication
and Accuracy
Request for Authorization Review
Our highly-trained staff review prospective, concurrent, and retrospective requests for treatment authorizations against nationally accepted evidence-based guidelines. Our efficient process speeds up requests for authorization, resulting in quicker approvals and improved effectiveness.
Physician Peer Review
Our physician peer review panel consists of URAC accredited IROs (Independent Review Organization) who provide experienced, actively treating physicians in a wide range of specialties. Every review is conducted by licensed professionals and tailored to specialty requirements in compliance with state regulations, ensuring robust and defensible determinations.
Quality You Can County On
Our strict quality assurance ensures compliance with all state mandated regulations as well as URAC standards for Workers’ Compensation. Ongoing educational seminars ensure comprehensive understanding and compliance with trends and regulation changes.
Our Proven Methodology
- Cost-Containment: Focused on reducing medical and indemnity expenses while ensuring appropriate care for injured workers.
- Compliance: Adhering to state regulations, fee schedules, and legal requirements for treatment and billing.
- Coordination: Streamlining communication and workflows between providers, payers, employers, and injured employees to optimize outcomes.
The Result
The Athens approach directly affects the bottom line. Superior results are achieved by delivering better quality patient care and improved health results while lowering employer claims costs.