ACME offers medical bill review, utilization review, and Medical Provider Networks.
In addition, we have developed strategic alliances with various Managed Care Companies
Medical Bill Review
All medical bills are reviewed for reasonableness, accuracy and compliance
with the current California Official Medical Fee Schedule (OMFS). Contracting
PPO providers are identified and the medical bills are re-priced according to
contract rates. Reductions are between 35%-80%, averaging 58%.
All employers are required to have a UR plan filed with the Division of Workers’
Compensation administrative director as governed by Labor Code section 4610 and
regulations written by the CA Division of Workers' Compensation (DWC), which lay
out timeframes and other rules for conducting UR.
Application of California’s evidence-based, Medical Treatment Utilization
Schedule (MTUS) for all approvals and modifications / denials
Turn-around times consistently above California guidelines
Prospective, Concurrent and Retrospective reviews
Pharmacy / Drug utilization reviews