Peer Review - Evidence-based medical review by board certified medical specialists who thoroughly reviews and assesses the medical and non-medical documentation provided.  Evidence-based factors will be utilized to support factors such as physical impairments, functionality, restrictions and limitations, treatment recommendations, severity of diagnosis and other requested issues.

Peer-to-Peer Reviews - Included as part of the Peer Review process, the reviewing physician will attempt to contact the attending physician(s) in order to gain a better understanding of the facts and circumstances surrounding the claim.  Such contact allows the reviewing medical specialist to gain firsthand the attending physician’s perspective related to the diagnosis, treatment, impairment, disability, etc.

Multi-Disciplinary Panel Review - A multi-facet review performed with multiple medical professionals of different specialties/sub-specialties.  Each medical professional will perform a comprehensive review of all available medical and non-medical evidence in consult so to determine “all factors” defining an individual’s working diagnosis, physical/mental impairment, disability status and treatment recommendations.

Plan Language Interpretation Review - Evidence/opinion based medical review by board certified medical specialists that determines an individual’s “disability” according to the specific criteria and unique factors of the respective plan definition of disability.  The plan definition of disability is reviewed thoroughly and decided within the report.  The corresponding medical documentation is specifically applied according to the uniquely defined definition and criteria of the plan definition of disability.

Workers' Compensation - Medical review by a practicing board certified medical specialist providing a retrospective review of medical treatment in order to determine various factors; medical necessity and appropriateness of care, the treatment rendered, causal relationship to the accident/injury, the impact of pre-existing conditions, disability status, further treatment recommendations, etc.

Medical Necessity - Medical review by a board certified medical specialist who will evaluate the care of the insured so to determine the medical necessity, investigational/experimental care and fraud and abuse.  If applicable, the medical specialist will clarify plan language, medical guidelines, etc.

Functional Capacity Evaluation with Clinical Evaluation - Medical assessment by a board certified occupational medicine specialist who medically validates an individual’s current functional capacity based on the results of the FCE, current medical diagnosis, past medical course and any other medical/non-medical factors.  The physician will correlate the findings with the Functional Capacity Evaluation  to help validate/invalidate the results of functional testing based on the current medical condition of the individual.