With the cost of healthcare nationwide rapidly increasing, many state governments and private companies are finding it necessary to take a pro-active approach to healthcare through Utilization Management of medical care and proposed treatment. CorVel’s certified Utilization Management Programs review proposed care to determine: appropriateness, frequency, duration, and care setting.
Utilizing our experienced staff of Registered Nurses, Medical Directors, and a large panel of Board-Certified Physicians, unnecessary treatments and associated costs can be eliminated. Our program is enhanced by our expert systems technology and the use of nationally recognized medical treatment protocols.
CorVel’s Utilization Management Program Can Include:
- Prospective review
- Retrospective review
- Concurrent review
- Second Opinion
- Peer Review
- Independent Medical Evaluation (IME)
Features
- Medical treatment plan review
- Patient channeling to preferred providers
- Coordination with patients and providers
- Proactive approach
- Well-defined dispute resolution process
- Compliant with URAC standards
Benefits
- Access to experienced Utilization Review professionals
- Reduce over-utilization
- Streamline coordination of care
- Control medical costs while ensuring quality of care
- Provide all supporting documentation for care
Selection of Evidence Based Medical Guidelines Utilized
- ACOEM – Medical Practice Guidelines
- Official Disability Guidelines – Work Loss Data Institute
- Medical Disability Advisor
