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Nurse Review Services

Experienced medical professionals available to provide guidance on First- and Third-Party Claims

Complex claims, whether First Party or Third Party, are at higher risk for costly errors. To lower the risk, you always want the most experienced giving those claims higher attention. But sometimes it's not possible for all complex claims. That's where our Professional Services can help. We have assembled a highly-skilled and experienced team of medical professionals who are available to provide deeper insight, guidance, and personalized service in a variety of areas. It's a medical team who average over 10 years each in clinical experience, medical utilization review, and medical bill review.

Auto Casualty Solutions Professional Services

Some areas our Professional Services Team can help are in

  • Relatedness of the diagnoses and treatment 
  • Treatment patterns: gaps, timing, duration
  • Medical necessity and efficacy of new procedures and technology

Together, we have provided an unparalleled depth of medical review services to more than 30,000 first- and third-party injury claims each year across the country. Members of this team have earned and maintain a wide variety of professional certifications, including Certified Legal Nurse Consultant (CLNC), American Academy of Professional Coders (AAPC) Certified Coder as well as certifications granted by The American Board of Quality Assurance and Utilization Review Professionals (ABQAURP).

Nurse review focus consists of

First Party:

  • Bill level review
  • Focused review
  • Relatedness and medical necessity
  • Coding review

Third Party:

  • Focused Review – short format, issue focused review
  • Record Summarization – features a chronological record summary
  • Injury Claim Summary - Full chronological medical record summary and detailed negotiation points

Our Auto Casualty Solutions Professional Services Team is available to you on a per-bill or per-claim basis to provide you with professional comprehensive medical evaluation services.


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