Cost Containment ServicesCase Studies Case Study Summary - Utilization Review Cases The purpose of Utilization Review is early identification of potential high-dollar and high-risk procedures and services. We target and medically manage the plan’s most costly services to determine medical necessity and review the proposed plan of treatment for medical appropriateness, determine whether the services should be provided and if…
Cost Containment ServicesConsulting & Reviews Targeted Reviews MRC provides a range of additional consulting services including reviews of specific services, providers, diagnoses, procedures, members, or employer groups. Medical Consultation and Research We frequently field questions related to appropriateness of treatment, effectiveness of treatment, clarification of diagnoses, experimental treatments and procedures, and validity of claims. We explore the complete range of…
Cost Containment ServicesLife Care Planning Medical Rehabilitation Consultants, Inc. provides Life Care Plans for legal and insurance needs. The plans are produced by a Certified Life Care Planner through consultations, client visits, assessments, record review, research, and background knowledge. A Life Care Plan is a dynamic document based upon published Standards of Practice, comprehensive assessment, data analysis, and research, which…
Cost Containment ServicesBilling Reviews Hospital Bill Reviews / Audits Medical Rehabilitation Consultants hospital bill review/audit program identifies any discrepancies in the hospital services being billed. The hospital bill will be pre-screened to identify any services which will require in-depth analysis. If an onsite review is determined to be necessary, in-depth hospital review is conducted at the hospital. An in-depth review…
SFUR defines medical cost containment as the process of leveraging medical and business knowledge to potentially lower the cost of medical bills.
We provide review, assessment and negotiation of medical cost, using a variety of methods which include, Separation of Charges, Coding Validation, Medical Necessity, State & Payer Specific Rules and Reasonable Charge Analysis.