Workers’ CompensationCase ManagementUtilization Review Management

Utilization Review Management

Expediting recovery by driving quality, timely care.

Using evidence-based guidelines, we look at every step of care to determine medical appropriateness and help protect injured workers from unnecessary treatments and costs.

a smiling businesswoman on a computer learning about corvel's workers comp utilization review management
What’s included in our program:
Prospective review
Utilizing nationally-recognized guidelines, our nurses verify the medical necessity of inpatient admissions, outpatient surgeries, and high-cost diagnostic procedures to help reduce needless treatment, stays, and procedures.
Concurrent review
We continuously evaluate an injured workers’ hospitalization. This ongoing review ensures that the injured workers’ care is progressing and that a continued hospital stay is warranted.
Retrospective review
This review is done when an injured worker receives treatment that was not pre-certified. We will certify the treatment or forward the case to a board-certified physician advisor for review if protocols are not met.
a female doctor working on a tablet using corvel's utilization review management
SAVINGS IN EVERY WAY

Keeping care up and costs down.

Our utilization review program is designed to ensure that injured workers receive high-quality, timely medical care. We address unnecessary treatments and spending to guarantee cost-effectiveness and better outcomes.

CareMC Edge

Intuitive solutions backed by innovative technology.

CorVel’s integrated technology capitalizes on our nurse’s clinical expertise, provides the entire claim team visibility, and promotes real-time collaboration. Our all-in-one platform combines personal attention and professional expertise with advanced technology to bring the most comprehensive capabilities that help injured workers recover faster and maximize savings.

CareMC Edge

Insights

Insights
Press Release05.01.23

CorVel Announces First Generative AI Initiative to Transform Claims and Case Management

Blog03.31.20

Case Management Support for Injured Workers

News09.08.21

Risk & Insurance: Why Nurse Case Managers Are the Perfect Champions for the Biopsychosocial Model in Workers’ Comp

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Our team is ready to answer any questions and help you find the right solutions.