Services

 

We provide initial, appeal, concurrent, prospective, and retrospective medical reviews for Group Health, Pharmacy Benefit Management, Medicare & Medicaid, and Workers' Compensation cases.

With one of the largest and most competent review panels of physicians and allied health professionals in the industry, we pride ourselves on the clinical excellence that we provide our clients. In all facets of our work, we are guided by our company belief statement- we believe every patient should receive quality healthcare. 

Group Health

AMR provides a broad range of services to group health organizations, for both commercial and government sponsored programs. Our physician and allied health reviewers assist in decision making for UM and Appeals’ Depts, provider quality, SIU, financial integrity and more. Our clients frequently request short turnaround times, peer calls and high-volume, special projects within a short period.

Pharmacy Benefit Management

Our pharmacy benefit review services and customizable technology allow payers with continually growing workloads to get a quick and independent outcome. AMR also provides PBM clients greater opportunities to reduce prescription drug costs through enhanced accountability, options, and operational performance.

Medicaid / Medicare

AMR excels in delegated Medical Director services for Medicaid/Medicare. We provide coverage after hours, weekends, and holidays as an adjunct to a client’s internal MD staff while complying with all NCQA and contractual regulations. 

Workers' Compensation

URAC-accredited in utilization management, AMR understands when to deploy the appropriate clinical guidelines by state. ODG, ACEOM and state-specific guidelines are utilized by our physician consultants who understand the nuances of workers’ compensation. 

Additional Review Services

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Our platform assists your operations with quick processing, data mining and specialized reporting. Customizable to your workflows and needs, the portal makes submitting, tracking and reporting on reviews of all types intuitive. Contact us to schedule a demo:

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