Independent Medical Review Services for Payers

The medical management & claims challenge.

Claims, utilization review and case management professionals face an avalanche of healthcare claims, appeals and pre-authorization requests, and are challenged to provide objective determinations under tight deadlines and other regulatory requirements. But increasingly complex medical procedures and drug treatments, along with constantly shifting standards of care, further complicate the job, making it almost impossible to maintain the specialist knowledge needed for timely, expert decision making. It is of little wonder today’s claims and UR professional is often overwhelmed by the need to ensure proper healthcare utilization, control claims costs and, at the same time, provide each member with the benefits he or she deserves.

Check out The AllMed Difference.

In order to ensure that plan members receive the care they’re entitled to while controlling unnecessary utilization, more claims and medical management professionals are partnering with AllMed.   With AllMed, high quality independent medical reviews delivered on time is only the start. AllMed delivers a complete knowledge-based solution that includes:

• Free, Instant Access to Doctors: AllMed’s in-house physicians and clinical team are available to provide free advice and consultation on cases, plan language and medical policy, via our MedConsult Hotline and online chat system.
• Evidence-Based Medical Updates & Best Practices:  Subscribe to our online publications or attend one of our webinars that cover emerging specialty medical treatments and hospital best practices; all designed to help your clients make better determinations based on better information.
• Online Reviews with PeerPoint Workflow:  Using AllMed’s secure online review software, you can send and receive cases electronically, monitor case status, and download automatic reports that help you identify trends and make medical policy adjustments.
• Online Collaboration through PeerPoint Network:  Anonymously collaborate with other professionals, our medical directors and peer specialists and access our Online Knowledge Base.  With PeerPoint Network, you gain access to a vast network of knowledge that will help you make better determinations in less time.
• 100% Client Satisfaction Guarantee:  AllMed offers an unconditional quality and turnaround time guarantee on every medical review to all of its clients.  If you’re not completely satisfied with every aspect of our service at any time, the review is on us and we fix it to your satisfaction, no questions asked.

Discover more about AllMed’s Independent Medical Review services and the value they can bring to your organization by watching our 3 minute movie. Or download our data sheets, case studies and guides. 

Click the following links to learn more about the other services we offer:

• Services Overview
  
• Utilization Review Support
  
• External Disability Review
• Medical Fraud Review
• Medical Director Services
• Drug Review for PBMs