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