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| Network Medical Review Co. Ltd. |
| 605 Fulton Ave. Suite 2002 |
| Rockford, IL 61103 |
| Ph: 815.964.6334 |
| Fx: 815.964.1162 |
| info@nmrco.com |
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| Services |
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| Workers' Compensation |
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| Workers' compensation (WC), which covers medical and rehabilitation costs and lost wages for employees injured on the job, is required by law in all 50 states. Each state is self regulated and the following requirements need to be verified in order to complete a WC referral: |
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Same State Physician Specialty Requirements |
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Same State Physician Licensing Requirements |
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Specific criteria guideline mandated |
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| NMR will assign a physician to review the medical records of the patient whose claim is being disputed. The physician will create a detailed report using the appropriate national guidelines to determine the opinion. The report then sent to the client within 24 hours for a medical necessity review and 72 hours for a PFR. |
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| Disability Insurance |
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| There are two basic types of disability coverage: short term (STD) (anywhere from 12 weeks to a year) and long term (LTD) (more than a year). NMR will assign a physician to review the medical records of the patient whose claim is being disputed. The physician will create a detailed report of this review which is then sent to the client within 72 hours for STD and 5 days for LTD. |
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| Type of Reviews LTD, STD: |
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| Independent Medical Evaluation |
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| These reviews can be scheduled for workers compensation or disability. NMR will recruit a physician in the specified area to evaluate the patient whose claim is being disputed. The physician will create a detailed report of this review, which is then sent to the client. |
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| Utilization Management |
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| Utilization Management services to various lines of business including the Workers' Compensation and Group Health. This Physician only Utilization Management Services Include: |
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Prospective Review |
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Concurrent Review |
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Retrospective |
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Review Reconsiderations |
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Appeals |
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