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Our Health Claims Services
We offer reviews in all medical specialties. Our review services include:
Physician Specialist Peer Review
- Medical, disability, pharmacy, work comp, behavioral health, fraud and auto cases.
- Review issues of medical necessity, procedural coding, experimental medicine, appropriateness of treatment, quality of care, plan coverage issues and length of stay.
- Each case review has a written report of findings, and listing of the reviewers credentials. Phone consultation, grievance and panel review, and ERISA appeal/fiduciary review available.
Outpatient Therapy Review
- Specialist review of speech therapy, chiropractic, physical therapy, occupational therapy, acupuncture, massage therapy and podiatry.
Outpatient Facility Review
- CPT and revenue codes assessed for proper coding and fees.
Coding Review
- Coding analysis/re-bundling and fee information for surgery, medicine, lab, diagnostics, anesthesia, and radiology.
Health Utilization Management
- For physical therapy, chiropractic, occupational therapy, acupuncture, and speech therapy.
- Addresses appropriate treatment durations.
Additional services are available. Please call us to discuss your exact requirements.
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