With so many new options for peer review services, it's important to be selective when choosing a medical peer review provider. Medical ReviewStream™ by Concentra can help you resolve complex or contested workers' compensation claims using board-certified physicians who offer a wide breadth of specialties. We provide pharmacy reviews, utilization reviews, complex chart reviews, Family Medical Leave Act (FMLA) Reviews, disability reviews, and claims adjudication services in a timely and cost-efficient manner.

Our medical opinion review services can not only help you contain medical costs, but also streamline your utilization review process, provide the Medical Advisor coverage you need, and help you ensure compliance with URAC, HIPAA and jurisdictional requirements. Medical ReviewStream™ is accredited by the URAC in Workers' Compensation Utilization Management. All reviews are performed in accordance with state-mandated requirements or URAC standards, whichever are more stringent.

URAC

As an industry leader, our knowledge, experience, and technology provides reliable evaluations through an extensive panel of expert Medical Advisors.

The Medical ReviewStream™ Difference


Accuracy — Every medical peer review case is thoroughly evaluated by an experienced Medical Advisor and then subject to our industry-leading Quality Management program
 

Timeliness — To help you comply with state-mandated timeframes, our Medical Advisors focus on providing timely and accurate recommendations when you need them
 

Communication and Accessibility — We maintain a consistent, open line of communication with our clients' operational staff and are available before, during, and after the completion of a medical review for questions or additional information
 

Reporting and Documentation — Once all necessary information is collected and analyzed, the Medical Advisor will create a detailed Physician Advisory Report, which clearly cites the appropriate, evidence-based criteria upon which their recommendation was based
 

Technology — While evaluating each referral, our Medical Advisors have access to an online reporting platform, where they can securely track and manage their assigned medical reviews. Medical ReviewStream™ also has the capability to implement EDI interfaces which can further streamline the utilization review process
 

Time and Cost Savings — We have established a panel of expert Medical Advisors and administrative staff to manage your medical review needs in the most cost effective and responsive manner possible - saving you time and money
 

Our Medical Peer Review Process

The Medical ReviewStream™ program handles all functions related to the peer review component of the overall utilization review process, including:

  • Location of a qualified Medical Advisor, based on URAC and jurisdictional requirements
  • Case assignment to a qualified Medical Advisor
  • Medical Advisor evaluation of all documents provided with the case, as well as the injured employee's medical history
  • Peer-to-Peer Consultation as needed when a Medical Advisor anticipates a non-certification based solely on the information provided
  • Generation of a detailed Physician Advisory Report to outline the Medical Advisor's recommendation
  • All reviews are subject to our industry-leading Quality Management process
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Contact Medical ReviewStream™
Phone: 855-597-3498