Utilization Management

Certified by the Utilization Review & Accreditation Commission (URAC), MedInsights' utilization management services help clients administer workers' compensation programs more effectively. MedInsights achieved a 100 percent compliance score on its most recent URAC audit.

MedInsights' utilization management nurses and client service professionals:

  • Utilize recognized, evidenced-based state and national guidelines in making treatment determinations (e.g. Official Disability Guidelines, Presley Reed, American College of Occupational Environmental Medicine);
  • Follow state-specific workers' compensation rules for utilization and access to medical care and specialists;
  • Comply with state-specific reporting requirements;
  • Coordinate with physicians to provide consultations and peer reviews;
  • Negotiate optimal treatment program to expedite timely and appropriate return-to-work opportunities.

To request more information, pleaseĀ contact us.