Reviewer Responsibilities

Physician Reviewers are responsible for:

• Accessing the web site where they receive requests

• Providing reference to the appropriate medical guidelines used in arriving at their recommendation / determination

• Posting determinations in a timely fashion to support Concentra's turn-around-time performance goals

• Making an effort to reach treating physicians in the event additional information is necessary and/or if a recommendation for denial is anticipated

• Following all HIPAA and privacy regulations, policies, and procedures