Westlake Village, CA – CID Management, Inc. has expanded its URAC-accredited utilization review (UR) services to include an enterprise level as well as a per-incident clinical management suite of services collectively known as The Clinical Experience.
Under The Clinical Experience umbrella, CID now offers Clinical Help Desk, MD on Call and Physician Conversations, to help adjusters get fast answers and keep claims moving. “It gives adjusters quick clinical support so they can make informed decisions and avoid going through an entire UR process,” said CID Co-Founder/Managing Director Steven Cardinale.
Whether their organizations have contracts with CID or not, workers’ compensations claims managers can access The Clinical Experience and have services billed to the claim.
The Clinical Help Desk deals with simple questions and answers, such as definitions of terms or how to apply regulations in a certain jurisdiction.
For more complex issues, CID offers MD on Call, designed for organizations that do not have medical directors or when medical directors are spread too thin. Offering strategic direction and top-level medical advice, MD on Call provides in-depth solutions that require an analysis and process, such as changing a pre-authorization process, working with physicians in a network or appearing with attorneys in a deposition.
Physician Conversations address the impasse reached when a treating physician asks for something outside of medical guidelines and will not consider suggestions from a nurse case manager or adjuster. “Some treatment requests only need a simple modification and a physician-to-physician conversation does the trick,” Cardinale said. “We always connect the treating physician with a physician who is board certified in the same specialty, so there is a level of credibility and respect built into the process. Just a 10-minute call can prevent the UR-denied craziness that keeps so many claims on adjusters’ desks.”
Additionally CID’s technology tracks all the questions and answers and when synthesizing answers from numerous sources, cites the sources, giving clients complete documentation of the incident.
Source: CID/King Knight