Wondering where an IRO fits into the external review process? How about whether an RN versus an MD can approve or deny a case? Check out our infographic on The Life of a Group Health Case to learn about physician-level reviews and the role of an IRO in Group Health plans!
Category: Workers’ Compensation & Utilization Management
The opioid crisis continues to loom in healthcare, as more individuals become addicted to and die from lawful and illegal forms of opioids. While controlled substances such as heroin are to blame for much of the problem, prescription medications are also a contributor. Variation in how physicians treat chronic pain and non-nerve-related back pain and […]
The 21st Century Cures Act, the opioid crisis, and the cost of pharmaceuticals dominated the headlines of 2016, highlighting the importance of understanding how prescription drugs work in today’s healthcare industry. One valuable tool used by employers, health plans and pharmacists is Drug Utilization Review (DUR). AMR created a quick reference guide to DUR so you […]
The health plan you purchase today may not resemble the plan of your parents or grandparents at all. For decades, Americans received healthcare under the traditional fee-for-service system. Insurance companies reimbursed patients or payers based on every service provided to patients. This seemed logical on the surface, yet problems became clear as the industry realized […]
Many physicians are experts in their areas of practice, but the medical field is vast, and there’s no way for one doctor to be an expert in everything. It is impossible to keep up with each advancement for every condition or treatment option. That is why physicians and health care facilities use the peer review […]
We’ve talked about telemedicine before on the AMR blog, outlining some of the pros and cons, as well as addressing how it might be funded. This post focuses on workers’ compensation in rural areas, and how telemedicine could play a crucial role in improving healthcare experiences for rural workers. As a refresher, telemedicine is care […]
The United States has long heard it has an obesity epidemic. According to the U.S. Centers for Disease Control and Prevention, 36.5 percent of U.S. adults are obese, which leads to health problems like heart disease, type 2 diabetes, certain cancers and premature death. But being overweight is not just a problem for people in […]
Adults spend a significant amount of their lives at work. Some individuals have 9-to-5 desk jobs while others hold more physically demanding positions in agriculture, manufacturing and construction. Whatever the work environment, employees expect to be safe from unreasonable dangers and to be able to get up and go to work again the next day. […]
From the election to recent statewide regulations, Workers’ Compensation is bracing for big changes in 2017. Find out more in our infographic!
The goal of workers’ compensation is to support employers and workers in offering the benefits workers need to recover from injuries or support themselves after becoming disabled. Every state has a workers’ compensation insurance system and specific guidelines within which businesses and employees must work. While the system has worked for many years, in recent […]