At Vee Technologies, we provide clinical review services performed by our highly experienced, specialist physicians, and nurses who assess the care needs that were performed. Following the assessment, we provide a detailed report which determines the patient’s eligibility for continuing healthcare. Our claims review or utilization review services help health insurance companies research a request for medical treatment. Our physicians and nurses review such requests for specific services and procedures and then determine medical necessity and identify appropriate treatments for industrial injuries, motor vehicle injuries, and more. These services allow healthcare payers to minimize costs and determine whether the recommended treatment is appropriate or not.
The main purpose of our clinical reviews is to:
- Determine eligibility of coverage
- Precertification of medical services
- Processing the right claims
We examine a comprehensive range of medical records, which include but are not limited to the following:
- Tests ordered – laboratory, radiology, pathology, etc.
- Therapeutic/diagnostic services recommended
- Hospital discharge summaries
- Consultation from other physicians
- Ancillary services
Whether you want to determine the medical necessity, member eligibility, or just want to validate the coding accuracy for the services requested or rendered, we are here to help. With our suite services, you will be able to determine quickly whether the claims are genuine or whether there are fraudulent and material misinterpretations.