Founded in 2004, AMR is setting the industry standard in providing quality independent medical case review and utilization management services that are timely, customizable and affordable. AMR offers a single source solution for all of our clients' review and utilization management needs covering all specialties and subspecialties nationwide. Our highly trained compliance staff and specialized case review nurses are bolstered by a strong quality assurance process guaranteeing the highest quality standards throughout the review process. Our commitment is to our clients and their patients. We emphasize - throughout all the work that we do - continuous quality improvement, innovation and client satisfaction.
Healthcare Plan Payers
Third Party Administrators (TPA's)
State and Local Governments
HealthCare Consulting Organizations
Case Management Companies
Special Investigation Units
Pharmacy Benefit Companies
Advanced Medical Reviews is very proud of our success in providing outstanding deliverables and customer service. Here is what our customers are saying:
"I love how receptive the staff has been. Whatever need we have, and we have a lot, they have been able to create workflow that makes working with AMR seamless. We have a lot of specialty cases and we appreciate the huge network of reviewers AMR has to offer. With our short turnarounds times we feel confident that we can send a case to AMR and they will have the reviewer available and back to us on-time."
Anonymous, Lead Physician Advisor Support Representative
"I enjoy the simplicity of the software, the stellar customer service, and the attentiveness of our business owner/project manager. The reviews are almost always received back before the due date and time. The customer service team is attentive, kind and professional when communicating with our staff members."
Lindsay Welch, Clinical Business Analyst
Advanced Medical Reviews, LLC is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws. Equal Opportunity Employer - Minorities/Females/Disabled/Veterans
With the industry's largest independent physician review panel, our Board Certified physicians and licensed healthcare professionals cover an extensive list of medical specialties and sub-specialties, serving all 50 states. Our physicians have real-time access to clinical and regulatory information, leveraging AMR's proprietary database of reviews through our workflow technology. We serve as both an adjunct to internal decision making processes and are fully compliant with the state and federal external workflows.
Overuse of medications can inhibit patient wellness. Our Pharmacy Benefit Reviews take into consideration drug price, utilization and appropriateness of medications within the scope of the treatment plan. Our team of qualified specialists and physicians make sure that the medications being prescribed are needed and providing a benefit to the course of treatment. We focus on the patient and the desired outcome while ensuring the right drug, in the right amount, is providing the intended treatment.
As a URAC accredited company for Health Utilization Management, Advanced Medical Reviews understands the role that utilization management has in quality patient care. Utilization management, when done using an evidence-based approach, can uncover excessive treatment and expense while enhancing the quality and effectiveness of patient care. The goal in our review process is to make sure that patients are getting the care they need, when they need it.
Our innovative patent pending platform assists your operations with quick processing, data mining and specialized reporting. Our platform is intuitive and promotes operational efficiencies. Submitting, tracking and reporting on reviews of all types is easy. Customizable to your workflows and needs, the platform is one of the most secure in the industry.
VP, Enterprise Accounts
VP, Enterprise Accounts
VP, Enterprise Accounts
VP, Strategic Partnerships
Senior Account Manager
The healthcare industry has an increased need for advanced analytics which enable organizations to cost-effectively measure and improve outcomes and overall performance, enhance care coordination, improve care planning and management and reduce risks.
Even though fraud, waste and abuse are a prevalent issue in healthcare, they are certainly preventable. Some commercial health payers and healthcare insurance programs that are funded by the government (i.e. Medicare) employ an administrator to handle payment integrity, while others utilize a third-party resource.
The reasons most often given by physicians for overtreatment are fear of malpractice, patient pressure and difficulty accessing medical records. Despite these reasons, providers aim to reduce the number of unnecessary tests and procedures by ensuring processes and guidelines are in place to promote easy access to patient records and collaboration with others involved in the patient’s care.
Human error is inevitable, especially when there are so many people and processes involved in a business. Administrative errors tend to be more apparent in the healthcare industry though, due to the risk of human lives at stake.
About one-quarter of physician referrals in the United States go to specialists who are out-of-network, which can be very costly for health systems and medical providers. This ‘referral leakage’ occurs when patients seek out or are referred to an out-of-network physician by a healthcare provider.