Cost Containment

Studies show that the first hours and days following a work-related injury is the best opportunity to positively impact disability duration and control claim costs.

Sierra Nevada Administrators’ workers’ compensation Utilization Review and Medical Case Management programs are developed in partnership with the client to control both medical and indemnity costs.

Services include:

  • Monitoring medical care prescribed for the treatment of work-related injuries to ensure that it is both medically necessary and delivered in an appropriate setting
  • Assist the workers' compensation claims examiner in evaluating and managing
  • Outpatient and inpatient medical services
  • Outpatient and inpatient surgeries
  • Major diagnostic procedures
  • Catastrophic case management
  • Reducing indemnity costs by expediting early return to work (RTW) leading to earlier claim resolutions.

Our experienced staff consists of board certified physician reviewers and registered nurses. All cases meeting established and agreed-upon protocols are reviewed by a registered nurse. The nurse reviewer references clinical criteria to compare a proposed treatment plan with nationally established norms for the condition.