Rising’s physician reviewers have the proper experience, licensures, and qualifications needed to verify the medical necessity and appropriateness of treatment plans.
Evidence-Based Decisions, Confirmed
Helping payers reduce unnecessary care and medical costs, this effective utilization management tool can be used as part of Rising’s comprehensive care management programs or as a standalone service.
- URAC Accredited
- Prospective, Concurrent, and Retrospective reviews
- Pharmacy / Drug Utilization reviews
- National panel of credentialed, board-certified physicians
- Reviews conducted by physicians of the same specialty, ensuring their ability to handle the specific questions and issues related to the request
- Evidenced-based evaluations, using national or state-specific clinical guidelines
- Required for Utilization Review services when modifying or denying treatment