When dealing with workers’ compensation claims, a medical review company helps ensure that a worker receives both the appropriate and necessary medical care that allows them to go back to work.
Defining An Independent Medical Review Company
An independent medical review company is also called either an independent review organization or a peer review company. An independent review company does medical assessments. They are objective in their conclusions and work independently from any medical insurance company. Usually, you would request an independent medical review after exhausting an appeal process via your medical insurance provider.
Challenges Posed By A Workers’ Compensation Claim
Most of the challenges faced by those involving workers’ compensation claims are the same. Amongst these challenges you may find the following:
- An increase in the complexity of submitted claims
- An increase in healthcare and medication costs
- The health and lifestyle of an employee, i.e., diabetes, joint pain, obesity, etc.
- Changes in laws and regulations at a local and national level
- Data safety breaches
- Driving while distracted
- The rise in drug dependency
- An accumulation of trauma due to previous injuries or overuse of certain healthcare provisions or medications
- Mental health issues and the rise in post-traumatic stress disorders as found in police officers and other frontline workers
A professional medical review company would pride themselves on their experience and competency in handling these complicated issues while helping clients navigate the claims process. The involvement of qualified medical staff, administrators, and peer reviewers helps expedite the process.
How An Independent Medical Review Company Helps Both Employee And Employer
If you sustain an injury in your workplace, you may need to start a workers’ compensation claim. This could be a confusing, frustrating procedure. As an employee, you want to make sure your employer covers your medical expenses. As an employer, you want to make sure that any medical treatment given to an employee is pertinent to the injury and considered necessary and compliant with governing laws and regulations.
An independent medical review company uses the services of physician reviewers that give an unbiased view based on the evidence received. This allows for a streamlined review process, as each physician used is matched with the case at hand. Each an expert in their field, these experts use their expertise in ensuring a patient receives the correct treatment to return to work.
