Services

We provide:

 

Medical Case Management

Medical Cost Managers’ expert Case Management team is dedicated to providing timely, effective and quality care. We are goal-oriented and focus on efficient and effective plan of action. MCM is committed to identifying the needs of those we service. We implement excellent cost containment measures and produce optimal outcomes for our clients. Medical Cost Managers offers both field and telephonic case management service. Bilingual nurses are available.

Telephonic, Field and Catastrophic Case Management

Medical Cost Managers is committed to providing the highest caliber of comprehensive medical managed care, and vocational and rehabilitation management. Our team provides superior cost containment services while assisting injured parties in attaining their optimal functional capacities. With knowledge, stability and integrity, we are constant visionaries in our industry. Up-to-date on the newest models of practice and legislation, our expertise and creativity is expressed as value for our clients.

Utilization Management

Medical Cost Managers’ Utilization Management professionals offer medical necessity review of the following: prospective/precertification, concurrent/continued stay and discharge planning as well as retrospective review of services. We conduct review of medical necessity of treatment using evidenced-based guidelines. MCM’s service-oriented procedures ensure our customer is receiving the right care, in the right setting, at the right cost.

Vocational Rehabilitation Services

The Medical Cost Managers’ Vocational Rehabilitation services team is made up of licensed and master-prepared vocational rehabilitation counselors. Each counselor performs a thorough job analysis and testing and will assist in alternative job placement when the injured worker is unable to return to their pre-injury job. We strive to obtain appropriate and meaningful employment for the claimant. MCM is dedicated to achieving optimal outcomes for the injured worker, the payers, the employers and the providers.

Medical Bill Review

Implemented using the latest and most accurate technology, MCM Resources’ bill review services deliver timely and comprehensive reporting to our clients. We utilize State fee schedules and usual and customary rules when warranted. Our services include unbundling and identification of over-utilization.

  • 24-hour turn around
  • Excellent reports and explanations of review
  • Can accept bills via email, fax, mail, Electronic Data Interchange (EDI)
  • Available for all 50 states
  • Compliant with all state fee schedules
Litigation Assistance

Medical Cost Managers offers client-focused Legal Nurse Consulting Services that provide pertinent facts necessary to proceed successfully with a case.

Our services include:

  • Medical Record Review
  • Chronologies
  • Research
  • Identification of Standards of Care
  • Expert witness testimony
Life Care Planning

The Medical Cost Managers team is equipped with certified life care planners who identify the rehabilitation, long-term medical care, and domestic needs for the chronically ill or injured. We are experts at creating comprehensive life care plans which accurately project future costs. Our reports are clear, concise and easy to comprehend.

Future Medical Cost Protection

MCM’s Future Medical Cost Projection (FMCP) provides an unbiased recommendation of the future medical costs for an individual’s life expectancy to facilitate the reduction of over-utilization of medical treatment. Our customized report identifies pre-existing conditions, enabling you to support causal relationship determinations and provides expert advice for the reserve-setting process and settlement negotiation. Medical Cost Managers offers FMCP as a proactive measure to assist in recognizing potential Medicare Set-Aside (MSA) cases. We provide a separate complimentary MSA report with the purchase of the FMCP if an MSA is needed within six months from the FMCP.

Medicare Set Asides

The Medicare Secondary Payer Statute was created to prevent the shifting of financial responsibility from the primary payers to Medicare. It is law that Medicare’s interest be protected prior to any settlement of the medical portion of a claim for those individuals who meet certain thresholds. Medical Cost Managers offers our clients a solution to this requirement with quality Medicare Set-Aside Arrangements completed by Medicare Set-Aside Certified Consultants. Our comprehensive service is available nationwide and assists our client from development and submission through the final settlement. MCM’s team of professionals delivers a quality product that is accurate and appropriate. We not only produce a quality product for our clients, we also are your resource for the most up-to-date information related to the Medicare Secondary Payer Statute and Medicare Set-Aside Arrangements.