Reporting Capabilities

Physician Advisory Report

As the primary deliverable of the Physician Review service, the content and analysis provided by the Physician Advisory Report is all-important. In this section, we "walk you through" a sample Physician Review report.

Reported History

The reviewing physician provides necessary background information to provide both documentation of key dates and context for the assessment to follow.

Contact

Recorded in this section are the contacts the physician makes during the review process, including the contact information. At the request of the insurance adjuster, the reviewing physician will contact the physician providing the services, which promotes even deeper understanding of the case and/or the mindset of that physician. This creates a partnership during the process, involving input from key stakeholders before the final determination.

Medical Records Reviewed

The reviewing physician reviews all provided medical records that relate to the injury or condition in question.

Conclusions

In this section of the report, the reviewing physician provides and documents a complete clinical rationale with each determination. Concentra's Physician Review program draws upon both internal and independent external physicians, with certified physicians covering all 50 states. For the purposes of oversight, quality assurance, and process management, these physicians employ a medical management model under the direction of our National Medical Director.

Criteria Utilized

Each Physician Advisory Report documents the nationally accepted, peer-reviewed criteria upon which the conclusion is based. Our affiliated physicians also rely on regulatory compliance updates that are researched, analyzed, and communicated from Concentra's Regulatory Affairs department.