Utilization Management

Preferred Case Management offers Utilization Management as an adjunct to our case management services.

What is a Utilization Review?

Utilization review is the evaluation of medical necessity, appropriateness, frequency, duration, efficiency and quality of medical care services provided to an injured employee.

Preferred Case Management's cerified Utilization Management Program utilizes an experienced staff of Registered Nurses, Medical Director and a panel of extensive Board of Certified Physicians.

Our Utilization management program is enhanced by our systems technology and the use of nationally recognized treatment criteria and protocols.

Our Utilization Management Program May Include:

• Concurrent Review
• Prospective Review
• Retrospective Review
• Peer Review
• Second opinion
• IME (Idependent Medical Evaluation)

Benefits:

• Timely Review and WC deadlines met per state statue
• Access to experienced UR professionals
• Reduce over utilization of treatment
• Ensure quality of care, while controlling medical costs
• Streamline coordnation of care
• Provide supporting documentation for UR based decisions