Facilitating Efficient Claims Review

Clinical Reviews (Workers Comp, Auto No-Fault)

At Vee Healthtek, we provide clinical review services performed by our highly experienced physicians and nurses who assess the care needs that were performed. Following the assessment, we provide a detailed report which determines the patient’s eligibility for continuing healthcare. Our claims review or utilization review services help health insurance companies research a request for medical treatment. Our physicians and nurses review these requests for specific services and procedures and then determine medical necessity and identify appropriate treatments for industrial injuries, motor vehicle injuries, and more. These services allow healthcare payers to minimize costs and determine whether the recommended treatment is appropriate or not.

Our Clinical Reviews:

  • Determine eligibility of coverage
  • Precertification of medical services
  • Processing the right claims

We Examine a Comprehensive Range of Medical Records, Which Include:

  • Tests ordered (laboratory, radiology, pathology, etc.)
  • Therapeutic/diagnostic services recommended
  • Hospital discharge summaries
  • Consultation from other physicians
  • Ancillary services

Whether you want to determine the medical necessity, member eligibility, or just want to validate the coding accuracy for the services requested or rendered, we are here to help. With our suite services, you will be able to determine quickly whether the claims are genuine or whether there are fraudulent and material misinterpretations.