Comprehensive File Review

A thorough review of an entire claim file, including all medical and diagnostic information, addressing the current state and course of action as well as formulating a suggested course of action toward file resolution.  Focus areas include, but are not limited to:

  • Causality of injury and compensability of treatment requests
  • Treatment utilization and return to work options
  • Comprehensive pharmacy review  including:
    • Opioid utilization
    • Long term toxicity
    • Interaction with comorbid prescriptions
    • Emerging drug review
    • Pain mitigation options
  • Physical medicine and diagnostic services utilization and efficacy
  • Use of catastrophic, home health and medical equipment
  • Comorbidity assessment and accommodation options / compliance (especially for STD/LTD claims)

This service is also available in a customized fashion to address specific questions posed by the nursing or adjusting staff and can be coordinated with our Independent Medical Exam and Peer Review services for maximum impact.