Utilization Review

Assisting Providers and Carriers in assessing the provided level of care to improve outcomes and contain costs.

Ensure that treatment requests are medically necessary for optimum level of care according to regulatory guidelines.

eData’s Reviewers have in-depth knowledge on ACOEM, MTUS, ODG and other evidence-based medicine that support treatment requests. They can also assist patients and physicians in the preparation of voluntary appeals of denied RFAs.

Our Reviewers and Analysts also assist claims adjusters in identifying the appropriateness of medical care, and mishandling of reimbursements.

Utilization Review Benefits

Experienced Medical Professionals

We ensure the best outcome by selecting professionals with experience in the appropriate field. Our medical professionals are nurses, doctors, physical therapists, pharmacists, and other medically-trained professionals.

High-Level Patient Care

Our attention to detail helps ensure that treatment recommendations comply with medical necessity standards.

Cost Savings

Contain costs and control abuse due to unwarranted medical treatments. We can point these out to you.

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