Utilization Review

Expediting Appropriate Care

At AMC, we have a single-minded utilization review (UR) goal - to help your employees return to work by providing the best, most appropriate treatment as quickly as possible. We hire and train the best people and streamline all systems and processes to support that goal. In States where allowed we provide our claims examiners with the training necessary to authorize treatment requests that fall within pre approved screening criteria. We also insist that our UR managers and directors attend State training seminars and conferences to stay current on the constantly changing UR process.

In addition, we support our people and yours by providing intelligent tools that speed and simplify the UR process, including our AlliedConnect database access service utilizing a unique web-based system that integrates all UR processes onto a single, secure platform. AlliedConnect database access services provides a shared workspace designed specifically to facilitate smooth, compliant reviews by connecting authorized participants with relevant, real-time information, accessible 24/7.

AlliedConnect service provides access to our on-line computer database in the field of outsourced managed care, medical, and disability cost containment services for treatment of injured employees under Workers' Compensation and related utilization review services, namely, a paperless, employer-accessible web-based database available 24/7 containing relevant information associated with an employer's outstanding Workers' Compensation claims under outside management, including medical treatment plans, treatment, hospitalizations, medications, medical devices/appliances and physical therapy, and costs associated therewith, which have been approved and/or have been incurred in connection with managed care treatment of injured and/or disabled employees claiming under Workers' Compensation programs.

Our UR team evaluates planned and provided medical care for necessity, frequency and duration through services that include:

  • Pre-Certification/Pre-Authorization reviews
  • Reviews performed by our medical director and specialty peer review network
  • Reviews based on national evidence-based treatment guidelines
  • National Accredited Utilization Management Organization

Allied Managed Care Inc. (AMC) has been awarded Workers' Compensation Utilization Management Accreditation from URAC, a Washington, DC-based health care accrediting organization that establishes quality standards for the health care industry. AMC is driven toward continual improvement of services by applying quality metrics and benchmarking to ensure we achieve top-quality performance consistent with the URAC Workers' Compensation Utilization Management Accreditation.

"Obtaining URAC accreditation demonstrates Allied Managed Care's commitment to providing quality services for our clients to help ensure that injured workers receive the best most appropriate care," said Mark Denison, Senior Vice President of Operations Allied Managed Care, Inc. The effort we put into our UR services results in excellent outcomes.

For more details or to arrange a demonstration of our system call (800) 431-6336.