"The sum of what has been learned evolves into ideas and skill that has been imparted"
In-house Medical Cost Containment, IME, Legal, Arbitration and SIU staff make these processes effective and efficient.
MEDICAL COST CONTAINMENT
A unit comprised of medical professionals. The function of this unit is as follows:
This unit consists of highly experienced Examiners, headed by a Supervisor Specialist.
INDEPENDENT MEDICAL EXAMS
Here exams are scheduled, the letters to the claimants and attorneys are initiated and sent, and within 48 hours of the exam the outcome is known. If an examination results in a negative outcome, this unit issues the denial no later than 72 hours after the examination, thus finalizing the medical reimbursement of treatment.
Medicals are reviewed for the appropriateness of the exam requested to ensure the most specific exam is performed.
The cost of our IMEs is minimal and cannot be surpassed. The product we deliver is comprehensive, professional and has the ability to overcome the arbitration process.
EXAMINATION UNDER OATH
As a result of all our investigative processes, when questions continue to go unanswered, EUOs are utilized.
Our EUO Department is adept in asking claimants, providers, etc. the questions necessary to elicit information upon when claims decisions can be made. Fraud remains an ever present obstacle to the success of our operation. EUOs are an effective tool in overcoming this danger.