Peer Review / Utilization Review / Concurrent Review
AGS completes evidence-based medical peer reviews for a wide array of clients in the healthcare and insurance markets. Each specialty-matched peer review delivers a comprehensive, evidence-based report that addresses case-specific questions. Members of AGS’s nationwide peer review panel are available to work with all insurance and market types, delivering expert and supported opinions for each case or client-specific needs, evaluating:
Our Features
- Causality
- Return-to-work concerns.
- Restrictions and limitations
- Standard of care
- Diagnosis
- Level of impairment
Additionally, Utilization Reviews comprise a subset of Medical Peer Reviews and answer questions related to the following:
- Appropriateness of treatment
- Medical necessity
- Whether a treatment is considered experimental in nature
Peer Reviews and Utilization Reviews are requested by and are completed for all insurance types AGS serves: Disability, Workers’ Compensation , Auto/PIP/Liability, and Health Insurance Plans. Utilization Reviews can be completed as pre-certifications (before treatment is provided), concurrent (while treatment is being provided), and retrospectively to a course of treatment.