MEDICAL REVIEW
HealthClaim Review® Medical Review utilizes specialist knowledge of board certified and practicing physician specialists from a panel covering more than 125 medical, allied health and dental specialties and subspecialties. An additional component to our medical review service is the application of correct coding and billing expertise by certified medical coders.
OUR MEDICAL REVIEW SERVICES INCLUDE:
- Chiropractic, Physical, Occupational and Speech Therapy Reviews
- Fraud & Abuse Identification
- Chemotherapy and Oncology Reviews
- Pharmacy + High Cost Drug Review
- Provider-Focused Post Payment Audits
- Dental & Oral Surgery Reviews
- Workers' Comp Coding & Bill Support
- Substance Abuse Facility and Level of Care Audits
- Long Term Care Policy Review
- Medical Necessity Review
- Medical Coding Appropriateness
- Quality of Care Review
- Appeals Case Determinations
- Plan Language and Benefit Coverage Questions
- Behavioral Health Reviews
- Physician Bill Evaluation
- Anesthesia Necessity, Coding and Pricing
- Surgical & Operative Report Analysis
- Disability File Determinations
