Menu

Review Services


Utilization Review

Research shows that adhering to the Official Disability Guidelines can shorten claim duration by 13% and cut medical costs by 38%

Utilization Review enables payers to assess treatment for medical necessity and incorporate evidence-based medicine into the care plan for injured people

  • URAC Accredited
    • URAC accredited for Workers’ Compensation Utilization Management
  • Nationwide Coverage
    • Coverage for all jurisdictions, including New York OnBoard PARs
  • Physicians Reviewers
    • Extensive, exclusive, and directly contracted physician reviewers
  • Final Determination Letters
    • User-friendly letter templates
  • Peer-to-Peer Communication
    • Successful peer-to-peer communication on 41% of UR cases
  • On-time Percentage - 99.98%
    • Our cutting-edge UR platform maintains organization and adherence to deadlines
  • Level 1 Reviewers
    • Leverage Physician Assistants for expedited approvals

Peer Review

Peer Review

An IME-like review conducted without an in-person exam, utilizing open-ended questions to obtain detailed physician recommendations

  • 50% lower cost compared to an IME
  • Minimized friction with injured individuals
  • Gather additional guidance before proceeding with an IME
  • Turnaround time of less than 7 days

Physician Pharmacy Review

Specialized physicians review the prescription regimen and suggest alternative treatments through peer-to-peer discussions

  • Specialized physician reviewer panel
  • Physicians exclusively contracted with Arbicare
  • Peer discussion rate of 75%
  • Provider agreement rate of 90%
  • Agreements captured in writing
  • Monthly follow-ups to support the implementation of agreed-upon prescription changes

Liability Clinical Review

Claims examiners face the overwhelming task of sifting through hundreds of pages of medical records and bills when assessing liability claims. Identifying relevant treatments, understanding the injury's progression, and determining what is directly related to the claim is time-consuming and complex.

Our service streamlines claim resolution by summarizing key details and reviewing bills to ensure accurate assessments.

  • Physician Assistants (PA-C) conduct case reviews
  • Each PA-C serves as a Medical Professional Level Consultant (MPLC)
  • Medical records are meticulously sorted and organized
  • Comprehensive report summaries highlight key takeaways
  • Unrelated treatments are identified and excluded
  • Bills are adjusted to reflect usual and customary amounts
  • Reviewers are available for deposition if required

Employees who are valued during difficult times are employees who recover

Make A Referral