On Site Utilization Management for TPA

MedWatch has a long history of successfully establishing on-site units in TPA offices. Our highly trained staff is readily available to the claims and underwriting staff to assist with claims reviews, bill reviews and the identification of disclosure issues. The TPA staff therefore has direct access to our nursing expertise.

 Advantages of In-house UR

• Services are customized to meet the needs of the TPA

• Needs are met as they are identified

• MedWatch provides:
  –Staff
  –Experience
  –Management/Supervision
  –Software
  –Physician review
  –Insurance/State certifications

• Review of Claims system for Trigger Diagnoses

• Interpretation of medical data

• Assistance in Group renewal process

• Medical underwriting assistance

• Access to preferred rates

• Access to MedWatch repricing entities

• Access to Transplant network

• The in-house unit can function as a profit center for the TPA

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