Utilization
Review
Briotix Health Can Help
Effectively Manage Workers' Compensation with Briotix Health's Utilization Review Program
Our systematic approach to Utilization Review results in condensed treatments and accelerated recovery. Focusing on therapy, understanding effective and necessary procedures, and an awareness of treatments set Briotix apart. Offering an innovative approach to utilization review by leveraging the power of provider-to-provider conversations, the Briotix Health Utilization Review program helps claims managers control costs while ensuring quality care for workers' compensation injuries.
Established Therapeutic Services
Our experts understand what treatment entails and ensure smooth communication from employees to supervisors and providers. Licensed PT/OT/DC practitioners ensure that there is no delay in care.
Targeted Utilization with Conversations
Our reviewers target treatment based on work requirements and medical necessities specific to your company. Peer-to-peer communication directly with all involved parties eliminates unnecessary therapies.
Focused on Functional Treatment
Our process includes a deep dive into the functional needs of your injured employee, directly impacting treatment procedures not just the number of treatments.
Benefits of Briotix Health’s Utilization Review Program
Briotix Health’s approach impacts the therapy outcome and utilization patterns by engaging PM&R providers with Briotix Health experts seasoned in coaching providers toward rapid functional recovery. This allows for a variety of benefits for both the employee and the employer.
Ensures medical necessity of care -
Our discipline-specific reviewers provide recommendations based on evidence-based guidelines, industry best practices, and individual employee needs, ensuring optimal care for your team members
Reduces unnecessary expense -
Our comprehensive reviews assess whether requested services are medically necessary or if fewer visits may achieve similar outcomes
Ensures continuum of care progress in a timely manner -
Our "focus on function" treatment approach optimizes physical restoration and a faster return to normal duties
Provides decision support for claims personnel and medical providers –
Our URAC-accredited process, including a clear, concise report, enhances voluntary compliance with treatment guidelines and fosters collaborative dialog between Briotix Health experts and their professional peers
Briotix Health’s Utilization Review Program
Step 1 -
Claims Manager needs assistance determining the medical necessity of requested treatments, products, or procedures
Step 2 -
Claims Manager contacts Briotix Health to begin Utilization Review Process.
Step 3 -
Initial clinical review based on evidence-based medical research and clinical review criteria
Step 4 –
Completed by a peer of the referring provider, may include a peer-to-peer conversation
Step 5 –
If requested following partial or non-certification decision
*As a value-added service, the Initial Clinical Reviewer may conduct a provider-to-provider conversation to review clinical status and certification status, conveying information back to the case manager.
Briotix Health's unique Utilization Review process significantly reduces therapy and rehabilitation expenses and fosters enhanced relationships with providers for future utilization discussions.
To learn more about a tailored Utilization Review program for your company, complete the form below.