• First Report of Injury
  ReviewWorks Rapid Report is our first report of injury product with improved services. We enhance this clerical function of claim reporting and documentation with claim triage to assess and provide timely claim and case management intervention.
  
  
• Provider Bill Review and Hospital Bill Review
  Unlike other bill review "engines" ReviewWorks provider bill review programs are custom built, integrating individual state laws, built in system edits, customized customer specific edits, and experienced medical professionals analyzing medical records in conjunction with the billed service. ReviewWorks consistent use of the latest technologies and service delivery options, helps you achieve MAXIMUM SAVINGS AT MAXIMUM SPEEDS, WITH UNPARALLELED ACCURACY!

• Utilization Management and Peer Review
  Utilization Management assists in controlling rising medical costs by evaluating medical necessity, frequency, compensability and duration of treatment.
  
  The Peer Review process is conducted by ReviewWorks contracted physicians and doctors of the same medical specialty as the treating practitioner who evaluate questionable medical records.
  

• Records Retrieval
  After our professional review process identifies specific medical records and notes required to conduct a thorough medical review, ReviewWorks record retrieval process notifies the provider, obtains the records and verifies the information.

• Out-of-Network Negotiations
  ReviewWorks experts negotiate and document additional discounts on out-of-network high dollar Provider and Hospital bills per customer specific guidelines.

• Coordination of Medical Benefits
  ReviewWorks Coordination of Medical Benefits (CMB) program addresses the claim adjuster's needs to offset benefits paid on coordinated and/or excess policies. Our exclusive CMB program obtains the primary carrier’s explanation of benefits (EOB) forms, computes the balance owed then verifies all Primary Payer activities on our Explanation of Review (EOR) for documentation of your net payment due.
  
  ReviewWorks has national affiliations with state specific Preferred Provider Networks, which result in substantial additional cost reductions. ReviewWorks contracted network providers agree to accept reimbursement below the applicable fee schedule or reasonable and customary rates.
  
  In additionally, ReviewWorks offers customized contracted provider administration of your Employer Preferred Provider Administration (EPO) arrangements.

• Reconsiderations
  ReviewWorks Professional Review staff responds to provider inquiries and telephonically resolves their issues when possible.
  
  
  • Reconsideration is defined as the review of a previously approved payment recommendation.

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