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Medical Evaluations
Independent medical evaluations can be arranged in all specialties throughout the country. IME’s may involve only set up, set up with extended file review, or they may be attended by one of our case managers in order to ensure that all issues on a case are properly addressed by the physician. These evaluations may be used on auto, liability, workers’ compensation, health, disability or FMLA claims.
Peer Reviews Peer reviews for first and third party claims are performed on files in which a physician’s analysis of the records and bills is needed in order to bring a claim to resolution. Our extensive network of physicians allows us to facilitate reviews in all areas of specialty throughout the country. Advanced Rehabilitation Management, Inc. is certified/approved for Act 6 Peer Reviews and Utilization Reviews in Pennsylvania.
One Shot Evaluations One shot evaluations are a tool utilized to assist adjusters in evaluating claims to assess current treatment and anticipated future costs. An on site visit by a qualified case manager is used to look at the extent of the injury, potential for complications, and future exposure.
Cost Projection/Reserve Analysis We offer this service to assist individuals who must set reserves on claims as a means of evaluating the severity of an injury and project future treatments and anticipated costs.
Liability Audits Third party reviews are used to help analyze medical specials packages in order to determine areas of exposure and reduce the overall value of the liability cases. File reviews are done by individuals knowledgeable in the medical field to reduce the total value of a case.
Bill Review / Bill Repricing ARM’s unique approach to bill review combines the expertise of our nurses along with the computerized repricing process. Utilization of a PPO is an option which may also enhance savings. By incorporating the involvement of ours nurse in the process, bills are evaluated more effectively. Nurses and physician experts may be incorporated into the program for real time negotiations on questionable claims to identify treatment plans or resolve disputed bills. The result is a defensible product with significant impact on the bottom line. Our experience in first and third party auto claims as well as in workers’ compensation allows us to be versatile to a variety of payers.
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