Worker Compensation Solutions
Workers Compensation Insurance Services Overview
SFUR provides medical necessity based review services to Workers Compensation Insurance payers to optimize Utilization Review & Management,, Medical Cost Containment, and Compliance, Fraud, Waste & Abuse.
SFUR has been providing high quality Utilization and Peer Review Services for 30 years and is a member of the National Association of Independent Review Organizations (NAIRO). We employ over 600 board certified Physician Specialists who we credential to the highest URAC standards every 3 years.
Our team of Certified Medical Audit Specialist and Professional Coders have successfully saved our Workers’ Compensation Payers customers millions in costs for reimbursements of hospital, ambulatory surgery centers and surgeon bills.
Our clients count on our exceptional medical knowledge, impartial reporting and timely delivery with the best prices of all Independent Review Organizations.
We value our clients by providing superior client service and support, and deliver results that exceed expectations and industry standards.
We are confident that we provide our customers the best price with the highest quality results of all Certified Utilization Review Companies.
Workers Compensation Cost Containment Solutions
Utilization Review manages medical aspects of claims in conjunction with ensuring injured workers are provided with timely and appropriate medical care. Over utilization of medical treatment is a driving factor in the overall cost of a Workers’ Compensation claim. SFUR, through the use of licensed nurses, board certified physicians and application of data driven evidence-based guidelines, addresses costs through a proactive approach.
SFUR defines medical cost containment as the process of leveraging medical and business knowledge to potentially lower the cost of medical bills.
We provide review, assessment and negotiation of medical cost, using a variety of methods which include, Separation of Charges, Coding Validation, Medical Necessity, State & Payer Specific Rules and Reasonable Charge Analysis.
SFUR is committed to improving the healthcare ecosystem. Both healthcare delivery participants and those entities that pay for healthcare, leverage the knowledge of the SFUR’s physician panelists. Monitoring compliance, fraud, waste and abuse starts with the SFUR physician panelists that can be impartial, objective and current in the knowledge and practice of their respective specialty.
The medical Utilization Review/Utilization Management (UR/UM) component for Medicare Advantage, Managed Medicaid and other managed care plans is a critical function that requires medical depth, breadth and resourcefulness. Members of SFUR’s physician panel have been providing Utilization Review for Medicare Advantage plans in thirty-two states for over ten years.