Prospective Review Services
Streamline the prior authorization process
Navigating prospective reviews in multiple workers' compensation jurisdictions can be overwhelming but it doesn't have to be. PRIUM's Prospective Review Services streamline this process with our powerful combination of experience, operational efficiency and technology. With PRIUM, you not only meet compliance deadlines but reduce claim costs and optimize injured worker outcomes.
Avoid costly jurisdictional fines
There are many available options for cost-effective, accredited prospective review services. That's why it's essential to work with a partner that offers clinical and jurisdictional expertise along with a commitment to operational efficiency. Otherwise, you could face costly fines or pay for unnecessary treatment.
PRIUM leverages our deep jurisdictional expertise and stringent review process to ensure that all prospective reviews are accurate and meet deadlines. In fact, our reviews are 100 percent on time. Here are five other reasons why you should consider PRIUM for your workers' compensation prospective reviews.
- Our 200 actively practicing clinician network encompasses U.S. jurisdiction medical specialties relevant to workers' compensation, giving us the expertise to evaluate the medical necessity of any type of treatment from medications to MRIs
- We make multiple attempts to engage treating clinicians in a peer review discussion. By focusing on an evidence-based discussion and calling at times when they are available, we are able to significantly reduce appeals
- Our eCase tracking system and streamlined operational processes are the backbone of our services—virtually eliminating paperwork, missed requirements and costly errors
- Regular performance meetings offer you transparency through a detailed report that outlines referral count, status of decisions, timeliness per jurisdiction and quality level
- Seamlessly integrate your prospective reviews with our comprehensive suite of managed care and medical intervention solutions designed specifically to eliminate directionless claims
The result? You meet all jurisdictional requirements and only pay for necessary medical treatment on your workers' compensation claims.
Available prospective reviews
Meet jurisdictional requirements. Integrate prospective reviews with our medical intervention solutions to obtain a complete clinical picture. Contact PRIUM and compare our utilization review services to your current solution.