Medical Case Management
The first days of a claim are critical in that the decisions made can greatly effect the course and outcome. Early referral will reveal claims needing Utilization Management to achieve Early Intervention. The process of making well informed claims decisions and implementing them can be greatly enhanced through early assessment of and intervention (if necessary) in the medical care provided. Potential problems or barriers can be mitigated early and a positive employer/employee relationship can be fostered. The use of professionally developed and defensible treatment criteria (ACOEM and Milliman Care Guidelines) allows us to optimize delivery of reasonable and necessary care.
Excel’s Reviewers, Medical Director and Specialty Physician Reviewers (Acupuncturist, Anesthesiologist, Cardiologist, Chiropractor, Dentist, Otolaryngologist, General Practice, General Surgeon, Internist, Neurologist, Neurosurgeon, Occupational Medicine, Ophthalmologist, Orthopedic Surgeon , Osteopath, Physical Medicine & Rehabilitation, Physical Therapy, Plastic Surgeon, Podiatrist, Psychiatrist , Psychologist, Pulmonary Medicine, Thoracic Surgeon ) are the backbone of this service. Excel will provide a comprehensive, quality driven utilization management tool to your claims organization. Our network of Physician Reviewers comes from a URAC Independent Review Organization.