Medical Peer Review Services
Specialized Medical Peer Review Services
Avoid unnecessary expenditures, reduce fraud, and make informed decisions regarding claim approval or denial.
Let us help you with medical peer review service that is compliant with state as well as federal regulations and requirements.
Our Professional Peer Review Services
We provide customized medical peer review services across a wide spectrum of medical specialties and subspecialties. Our dedicated team of peer review physicians meticulously evaluate the medical records, encompassing diagnosis, adherence to standard of care, extent of impairment, restrictions and limitations, and return-to-work considerations, to ensure the production of precise reports.
Our clients include review organizations, health insurers, physicians, and law firms, aiding them in effectively addressing intricate care management challenges, sentinel events, Workers’ Compensation cases, and liability claims.
We provide peer review services for the following evaluations.
- Short-term disability (STD)
- Long-term disability (LTD)
- Permanent/Total (PTD)
- Panel peer reviews
- FMLA clarifications (self and family)
- Functional capacity evaluations (FCE)
- Determining Medical Necessity
- Standard of Care
- Cost containment & payment integrity
- Quality of Care
- Resource Utilization
- Fraud, waste and abuse reviews
- Auto liability
- General liability
- Medical malpractice liability
- Product liability
- Personal injury liability
- Complex Pharmacy Reviews
- Causation Reviews
- Compensation utilization reviews
- FCE (Functional Capacity Evaluation)
- Impairment rating
Count on MOS Medical Record Review for a Customized Solution.
How We Make Your Physician Peer Review Process Easy
These process steps streamline the efficient delivery of comprehensive medical review support services.
- Team Assembly and Documentation Review: Our team, consisting of physicians, registered nurses, documentation specialists, editors, and proof readers, gathers and thoroughly reviews the medical documentation provided.
- Physician Support and Report Preparation: We collaborate closely with physicians to efficiently prepare reports that address critical aspects of the case, such as causality, injury, functionality, restrictions, treatment advice, appropriateness of medical care, and diagnosis.
- Missing Document Identification and Retrieval: We meticulously identify any missing medical documents vital to the case, taking proactive steps to retrieve them when necessary.
- Accurate Chronology Creation: We create precise and comprehensive chronologies that present a clear sequence of all medical encounters, recording essential details like date, time, and care providers.
- Concise Medical Summaries: Our team produces succinct medical summaries that effectively highlight the pivotal facts of the case.
- Compliance and Data Thoroughness Check: We conduct a thorough review to ensure compliance and data thoroughness throughout the process.
- Preparation of Peer Review Report: The final step involves the preparation of a well-detailed peer review report that serves to clarify all aspects related to the claim for the claimant, the physician, and the attorney.
The Peer Review Process at MOS
Why Choose Our Medical Peer Review Services?
- Expertise in clinical peer review
- Professional practice evaluation (OPPE) and peer review processes
- Compliance with regulatory bodies
- External peer review excellence
- Effective disciplinary actions
With our team, you can initiate a comprehensive medical peer review process that ensures the highest standards of healthcare.