Utilization Management

Care^IQ's utilization management program reviews proposed care to determine appropriateness, frequency, duration and care setting. Our experienced staff of registered nurses, medical directors and extensive panel of board-certified physicians help eliminate unnecessary treatments and associated costs. The program is enhanced by our expert systems technology and the use of nationally recognized medical treatment protocols.

• Prospective review
• Retrospective review
• Concurrent review
• Second opinion
• Peer review
• Independent Medical Evaluations

• Medical treatment plan review
• Patient channeling to preferred providers
• Coordination with patients and providers
• Well-defined dispute resolution process
• Compliant with URAC standards

• Access to experienced utilization review professionals
• Reduce potential for over utilization
• Streamline coordination of care
• Control medical costs while ensuring quality of care
• Provide all supporting documentation for care

• ACOEM – Medical Practice Guidelines
• Official Disability Guidelines – Work Loss Data Institute
• Medical Disability Advisor