Case Management and Utilization Review
Procura’s telephonic and field-based case management services provide sound medical alternatives that are effective and cost efficient and avoid unnecessary and inappropriate care. Delivered by registered nurses, our case management programs establish claimant advocacy and channels injured workers to accessible network providers, where jurisdictionally appropriate. Treatment is managed proactively based on guidelines designed to promote recovery and eliminate costs and in accordance with jurisdictional regulations. Procura’s case management programs are an effective tool for managing the coordination of medical care and meeting return-to-work objectives.
To align reasonable and necessary treatment while managing claim expenditures, utilization review services are embedded into telephonic and field case management services. Procura’s utilization review capabilities include pre-certification, independent medical examinations, peer review, medical director reviews and concurrent and retrospective auditing.
Contact a Procura representative to learn more about our Procura's case management and utilization review programs.
