Other Services

other services national medical reviews inc

NMR provides the services listed below for prospective, concurrent and retrospective medical reviews.

These services are available in standard as well as expedited time frames.

• Accident & Forensic Investigation Services
• Adverse Determinations Appeal Reviews
• Alternative Dispute Resolution
• Appropriate Coding & Treatment
• Benefit Coverage Issues
• Chart Reviews
• Claims History & Case Reviews
• Coding Reviews
• Complete Medical Records Reviews
• Consumer Grievance Issues
• Cosmetic Treatments
• Coverage Criteria Evaluations
• Disability Claims
• DRG Reimbursement Reviews
• Emergency Cases
• Expedited Appeals
• Experimental & Investigational Reviews
• External Appeals & Grievance Reviews (Level III)
• Functional Capacity/Disability Evaluations
• Foreign Language Translation Medical Reviews
• Forensic Medical Reviews
• Health Benefit Coverage Disputes
• Hospital Admissions & Length of Stay
• Hospital Accounting/Claims/DRG Reviews
• Impairment Ratings

• Independent External Medical Reviews
• Independent Medical Examinations
• In/Out Patient Pre-Certification
• Internal Reviews (Initial, Levels I & II)
• Level of Care & Impairment
• Malpractice Case History Reviews
• Medical Necessity Determination Reviews
• Medical Necessity External Reviews
• Panel Member Appeals or Grievance Hearings
• Peer to Peer Reviews
• Plan Language Development
• Predetermination Reviews
• Pre-Surgical Authorizations
• Provider Accounting Reviews
• Provider Appeals
• Provider Claims Reviews
• Psychiatry Reviews (Adult, Child & Adolescent, Addiction, Forensic)
• Quality of Care Reviews
• SNF RUG Appeals
• Thomas Love Medical Necessity External Review Process
• Transplantations
• Unusual or Disputed Claims Reviews
• UCR Audits

 

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