Total Managed Care, Inc

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Description

Total Managed Care, Incorporated views its mission as achieving the expeditious restoration of health and productivity to those who have lost them by illness or injury, and to minimize disability while maximizing ability retention. Our goal is to efficiently and effectively manage the medical recovery and return to work process, thereby increasing the return on medical expenditures, and lowering medical and indemnity costs. Total Managed Care, Incorporated has developed a comprehensive array of services to facilitate this goal including: Medical utilization review activities should be initiated when a question regarding medical necessity of any proposed treatment or service arises from any written request for service. It may also be initiated if an injured worker questions the necessity or validity of treatment recommendations. Total managed Care's Utilization Management Program meets the standards set forth in the Workers' Compensation Labor Code for approval, modification, delaying, or denial based in whole or in part on medical necessity. All certifications are performed by licensed RN's. All pre-certifications or reviews are criteria based, and subject to additional information from the provider. Total Managed Care's protocols for Utilization shall ensure that decisions are made on scientifically based evidence, and if they are not appropriate, will be sent for a physician peer review. Utilization Management includes

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