The purpose of the Cost Containment Unit is to analyze, review and recommend payment to medical providers, hospitals, ancillary medical providers, rehabilitation services and pharmacies.

  • Knowledgeable medical specialists, including registered nurses and physician advisors, along with state of the art software, help achieve maximum cost savings
  • Medical bill reviewer professionals analyze, review and recommend payment to medical providers based upon statutory rules or guidelines and/or provider reimbursement contract amounts
  • Medical reimbursements are reduced, on behalf of our clients, to the level appropriate in terms of:
    • Medical necessity
    • Treatment actually rendered
    • Adjuster authorizations
    • Usual or reasonable and customary charges
    • Utilization practices
    • Applicable fee schedules
    • Contracted agreements
  • Timely payments to providers meet statutory regulations on the type and amount of reimbursement and significantly reduce costs to clients

Workers' Compensation
Utilization Management

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