Cost Containment Services
Consulting & 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 issues as they may relate to the specific claim and fully utilize our research knowledge and capabilities as well as the services of our advisory team of physicians and therapists. We will also locate medical experts and schedule Independent Medical Exams. In addition, Medical Rehabilitation Consultants is very familiar with national Centers of Excellence in providing specialized, comprehensive care for complicated medical problems.
The efficacy of chiropractic care with certain musculoskeletal disorders is well documented. It is often difficult, however, to differentiate between curative and palliative care. Medical Rehabilitation Consultants’ nurse consultants are familiar with the expected outcomes of chiropractic care and can assist with determining appropriateness of treatment. A member of the Medical Rehabilitation Consultants physician advisory team, a practicing chiropractor, is available as a consultant to complete objective file reviews and perform independent medical evaluations as determined necessary.
Alternative Medicine/Therapy Reviews
The general acceptance of alternative medicine and therapies (i.e. massage therapy, naturopathic medicine, acupuncture) has created a new area of treatment being explored. As with all areas of treatment, it is often difficult to differentiate between curative and palliative care. Medical Rehabilitation Consultants‘ nurse consultants will review the treatments and examine the plan of care and the expected outcomes to determine the appropriateness and safety of treatment based upon the provisions of the benefit plan.
Review of medical records for medical appropriateness for services that were not pre-certified or concurrently reviewed.
A Medical Chronology is a record of medical events in the order of their occurrence. This involves reading through hundreds of pages of medical records to identify, locate, review and interpret relevant information from the medical records
Forensic Consulting and File Reviews
Retrospective Peer Review – involves the review of medical records after medical treatment has occurred.
MRC provides Medical Necessity based Medical Cost Containment, Utilization and Compliance Services. Our strong Physician based review services through our 800+ Physician panel covers every medical specialty and geographic requirement.
MRC expert medical witnesses are physicians qualified, by reason of their skill, knowledge, education, experience, or training to testify for a specific medical area. The physicians have the very specific knowledge and experience to be effective for the role that is required.