MedWatch, LLC…  Leaders in Medical Management

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MedWatch is a comprehensive, multi-service Medical Management firm providing services to the following range of clients:

• Insurance Companies
• Self-Funded Employers
• Third Party Administrators and their clients
• Workers’ Compensation funds

Medical Management Services

• URAC Accredited in Health Utilization Management
• URAC Accredited in Case Management
• Individually State certified
• Specialty-trained RNs with experience and maturity
• Staff trained to work with reinsurers, underwriters, brokers, claims staff and carriers
• 24-hour RN availability
• Immediate access to board certified physician advisors
• Services tailored to meet the needs of the customer

Utilization Management

• Proven record in reducing utilization
• In-patient medical necessity review and certification
• Out-patient procedure review and certification
• Medical/Surgical plus Mental Health/Substance Abuse Review
• MOM Program (MedWatch Obstetrical Monitoring)
• Diagnostic Follow-up
• Discharge Planning
• Independent Board Certified Physician review panel
• Reinsurance notification
• Nationally recognized and accepted medical review criteria
• Up-to-date reporting
• On-line precertification submission via our secure website

Medical Case Management

• Early case management intervention leading to decreased medical expenses and better clinical outcomes
• Access to tertiary care facilities and networks
• Fee negotiations
• Contracts with transplant networks
• Care coordination
• Catastrophic disease/illness management
• Patient education
• Innovative solutions to complex cases
• Compassionate advocate and resource for patients and families
• Comprehensive, timely reporting

Disease Management

• Patient centered process with individualized plan
• Health Risk Assessment
• On-going communication involving the patient and health care providers
• Education focused on wellness and lifestyle management
• Education of disease process
• Internet-based disease information and healthcare tracking system
• Outcomes reporting

Other Services …

• Medical Help Hotline
• Demand Management (24-hour Nurse Line)
• Disability Management (STD, LTD)
• Workers’ Compensation Management
• MedWatch In-House Management

A service for our Third Party Administrators so they may achieve the following:

·        On-Site Nurses

·        Secure an experienced All-Current Claims Administration process with on-site nurses

·        In-house access to medical expertise

·        Faster claims turnaround

·        Marketing edge created by on-site nurses

·        Decreased cost to employer for UM services

·        Added revenue/profit center for TPA

MedWatch, LLC is…Innovative, Creative,

and willing to work for you!