San Jose, CA – EK Health Services, Inc. (“EK Health”), a national workers’ compensation managed care company, has added liability review to its line of managed care services.
Backed by vast expertise in medical review and case management, EK Health liability reviews examine and interpret medical records associated with general liability and auto liability claims, helping payers in settlement discussions and negotiations to reduce claim costs.
The reviews are conducted by EK Health Liability Nurse Specialists who utilize recognized clinical guidelines combined with proprietary technology to scour claims reports and identify any medical treatment that is inapplicable to the file.
EK Health liability reviews focus on medical appropriateness and treatment protocol. The approach provides important tools to claims managers of employers, insurers, third party administrators and other payers, helping them avoid unnecessary payment for medical treatment deemed outside of accepted clinical guidelines for the injury.
“The nurse case managers on our liability review team are trained to pay attention to detail,” said Sherry Busbee, EK Health’s Assistant Vice President of Case Management. “They have clinical expertise that produces a significant impact on the overall cost of the liability claim, and bring a clinical mindset to the claims adjudication process.”
EK Health also offers physician peer review services for medical treatment evaluation applicable to liability claim settlement, if appropriate.
Source: EK Health/Estes & Co.