Services
Provider Review Services
and Products
- Concurrent Review
- Retrospective Review
- Appeals/Second Opinion Review/third party arbitration
- Chart Audit/Coding Review for appropriateness and accuracy (To enhance quality improvement programs & optimize reimbursement)
- Coordinating Functional Capacity Evaluations (FCEs) and other "Objective Findings"
- Legal Consulting - Review for litigation/settlement including expert testimony
AUG - Provider Review Goals
- Serve as a patient advocate to ensure that each patient receives all of the care they need in order to reach their maximum rehabilitation potential.
- Facilitate fair claims by making sure each patient receives care that matches their clinical need.
- Facilitate communication between providers and payers by having reviews performed by professionals with an appropriate body of knowledge. These knowledge-based practice parameters will help assure efficacy of treatment, increase the probability of a positive clinical outcome, and help speed settlement negotiations.
- Flexibly design quality products and services in the utilization management industry that exceed customer expectations. We will deliver these services maintaining the highest standards in customer service, staff credentialing, and timeliness at a competitive cost.
- Educate our customers about effective rehabilitation services to facilitate win-win-win situations between patients, providers, and payers.