Who We ServeMedicaid Plans MRC Medicaid Plan Solutions MRC provides nurse case management consulting and social worker services to assist Medicaid health plans in caring for their member population. We deliver person-centered medical case management regardless of the member’s social determinants of health. One of our long-term objectives when possible is to have members become contributing members of their local…

Who We ServeERISA Employers MRC Self Insured Employer ERISA Plan Solutions Self-insured health plans are regulated under the federal law (ERISA) which stands for Employee Retirement Income Security Act. At MRC, a sizeable portion of our customer base operate as self-insured group health plans (or a 'self-funded' plan as it is also called) where the employer assumes the financial risk…

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.

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.

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…