UTILIZATION REVIEW
We understand that each injury is unique, so we don't use a generic list of referral criteria. InterMed's Utilization Review process benefits clients by identifying prior treatments and validating the treatment plan and diagnosis. Our Utilization Review also channels care into a PPO/MPN whenever possible.
Professional Nurse
Reviewer
Review medical history, treatment plan and documentations to identify if medical necessity has been met. Reviewing for medication necessity ensures treatments are not over-utilized, safe and met evidence based medicine criteria.
Medical
Director
Medical Director provides strategic medical guidance and opinions and quality assurance based on evidence based medicine in accordance to statutory guidelines. Consults on complex cases and offer safe and medically necessary care advice.
Peer
Review
Board certified physician reviewers review medical information based on evidence based medicine to determine appropriateness. Peer to peer, when appropriate is attempted to offer treating providers an opportunity to provide additional medical rationale for consideration.
Specialty Peer
Review
Access to a network of over 15,000 board-certified, active-practice physicians and healthcare professionals covering over 100 specialties. Specialty reviewers are knowledgeable in worker’s compensation and provide quality reviews based on their expertise.
