Amalgamated Medical Care Management offers Independent Physician Review Services for hospitals, health care systems and managed care organizations nationwide. These services support the full array of state and federal regulatory-mandated appeals in full compliance with URAC, as well as all “Patient Protection and Affordable Care Act” requirements.
A full scope of Physician Review services feature:
- First level pre-certification/concurrent review
- First and second level appeals
- Expedited appeals
- Retrospective services
- Investigative/experimental assessments
- Medical claims reviews including coding
- Physician consultation
- Quality of care assessments
- Disability and Accidental Death and Dismemberment (AD&D) reviews
- Pharmacy reviews
- Accredited pursuant to URAC standards
Amalgamated’s Physician Review Services rely on a network of over 250 doctors in 70 different medical specialties; an important attribute when appeals occur and require the expertise of a specialist.