Our Products / Services
MEDICAL COST CONTAINMENT
Integra Medical Management is a wholly owned subsidiary of Hammerman & Gainer that provides Medical Cost Containment Services. We believe medical costs should be managed by employers and payers together to help reduce the cost of delivering quality healthcare services. Our services include:
- Cost Containment Reviews: Our team of experts review where your medical dollars are being spent and devise strategies to reduce them. Plans and recommendations are developed jointly with the client.
- Pharmacy Program: Studies show that drugs and medications are a major cost to employers. These studies further show that merely cutting prices is not enough. Our program focuses on managing these costs and lowering utilization.
- Early Intervention: An Integra case manager reviews a case for potential impact within 24 hours of the injury being reported. By contacting the employee, his/her supervisor, and the treating physician, the case manager assesses the issues around medical treatment, recovery times, and return to work. A plan is developed jointly with the employer and the adjuster.
- Case Management: A case manager's job is to return employees to work; resolve complicated medical issues; and assure proper care for injured workers. We use highly experienced telephonic nurses who work as a team with adjusters and employers to achieve these results. Field nurses are used on catastrophic cases and for specific assignments.
- Utilization Review: Our nurses have access to the nationally recognized Official Disability Guidelines and the Medical Disability Advisor. These guides set benchmarks and assist our nurses in making proper referrals to outside physicians for determining medical necessity and relatedness to the injury.
- Medical Bill Review and PPO Networks: Our state of the art system reviews cases and not only reduces bills to the state fee schedule and PPO discounts, but will also review for proper billing procedures, unbundling of charges, duplicate billing and relatedness. On larger out of network bills, we will negotiate with the provider for a reduced fee.
For additional information, contact us at (888) 899-8432