Medical Management

As part of our comprehensive portfolio MedWatch Medical Management provides a variety of health care medical management review services that promote adherence to evidence-based medicine, support delivery in the most cost-effective care setting, and are designed to reduce the likelihood of care that is unnecessary or unsafe.

Medical Necessity Determinations are a prospective, concurrent or retrospective review of treatment by a MedWatch Medical Management physician to determine if the treatment is reasonable and necessary for the diagnosis or treatment of illness or injury or to improve function under the provisions of the applicable health benefits plan.

Utilization Review Services utilizes a physician directed group of MedWatch Medical Management Registered Nurses to evaluate the medical necessity, appropriateness and efficiency of the use of health care services, procedures and facilities.

Case Management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy. Case management engages with patients and their caregivers to provide educational support to families and identify resources to improve overall care.