Benefits of Outsourcing

The Concentra Physician Review program serves a variety of clients, each with a unique set of needs. As a member of a utilization review company, insurance carrier, third-party administrator, or large self-insured employer, you may be looking for ways to outsource the physician review service. Your reasons could be:

• You already have physician review outsourced but want to consider other providers for quality and/or cost reasons.
• You provide utilization review and physician review in-house but want to outsource the service to save money and labor.
• You provide these services in-house but need periodic help with overflow or backlogged cases.
• You need a physician review service and want to select the best service provider.

For all of these reasons, Concentra should be considered as an outsource partner. Consider the following cost and time savings that could result for you.

Time Savings = Cost Savings

Your UR nurses may be spending anywhere from 30 to 60 minutes per case that requires physician review. Each time they have a case that needs physician review, they have to:

• Locate a board-certified, credentialed doctor to perform the review
• Find out if the doctor is available to accept a case
• Forward a request and clinical records
• Follow up with the doctor
• Review the physician's determination for spelling errors and responsiveness to the request
• Reassign any reconsiderations and/or appeals

The Concentra Physician Review program can perform all of the tasks listed above, saving your nurses valuable time. Depending on a number of factors, the Concentra Physician Review program may save each of your nurses close to two hours per day.

Moreover, this does not include the additional savings in provider network management and medical oversight expense.

Claim Savings Return on Investments (ROI)

Using the same approach to calculate potential savings that result from shifting the claim load:

• Average Physician Review Cost/Review: $225
• Average Savings/Review: $1,759
• Return on Investment: 7.8

If you would like more information on the time and cost benefits your company could realize, we would be happy to discuss your particular situation if you contact us.