Review Services

Utilization Review

Researchers have concluded that compliance with the Official Disability Guidelines has been shown to reduce claim duration by 13% and reduce medical costs by 38%. Utilization Review allows payers to review treatment for medical necessity and inject evidence based medicine into the treatment plan for the injured worker.

  • URAC Accredited
    • URAC accredited for Workers’ Compensation Utilization Management
  • Nationwide
    • All jurisdictions including New York OnBoard PARs
  • Our Physicians
    • Exclusive and directly contracted physician reviewers
  • Reports
    • Easy to read letter templates
  • Peer to Peer Communication
    • Successful peer-to-peer communication on 41% of UR cases
  • On-time Percentage - 99.98%
    • Our software platform keeps us organized and on-time
  • Level 1 Reviewers
    • Use Physician Assistants for faster approvals

Peer Review Services

Peer Review

IME-like review without the in-person exam. Open ended questions to receive evidence-based physician recommendations.

  • ½ cost of an IME
  • Reduced friction with the injured worker
  • Learn more before pursuing an IME
  • <7 day turnaround time

Physician Pharmacy Review

Speciality matched physicians review the Rx regimen and recommend treatment alternatives through peer-to-peer discussion.

  • Specialized physician reviewer panel
  • Directly contracted physicians that only work with Arbicare
  • Peer discussion rate = 75%
  • Provider agreement rate = 90%
  • Agreements captured in writing
  • Monthly follow-up to encourage agreed upon Rx changes

Demand Package Review

Attorneys demand high dollar settlements regardless of the claim worth. Get clinical help before negotiating.

  • Physician Assistants (PA-C) review the case
  • Each PA-C is a Medical Professional Level Consultant (MPLC)
  • Sorted and organized medical records
  • Clear report summary with key takeaways
  • Display unrelated treatment
  • Reduce bills to usual and customary amounts
  • Reviewers deposed if necessary

Employees who are valued during difficult times are employees who recover

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