Utilization Review
Opportunities:
- Manipulation treatment, Chiropractic
- Physical therapy, Occupational therapy
- Acupuncture
- Diagnostic testing [MRI]
- Durable Medical Equipment [DME]
- Injections [ESI/Nerve Block]
- Inpatient and outpatient surgery
- Discharge planning needs [SNF, home health, transportation etc.]
Other Services:
- Line‐by‐line bill audit
- Line‐by‐line EOP audit
- Comprehensive medical chronology
- Data profiling
- Coding validation
- Drug review assignments
Reports Typically Include:
- Date of Review
- Level of Review
- Patient Name
- Date of Birth
- Date of Injury
- Diagnosis
- Surgery Requested Treatments
- Determinations
- Medical chronology and medical record review
- Medical record summary
- Rationale for Determinations
- Per below referenced medical evidence
- Additional information by client request