Consulting Services

Consulting Module #9

Quality Review: Internal Clinical Resources

You probably have a good sense of how many clinical reviews are being completed, but do you really know whether the quality of the input is truly driving appropriate claim direction?

PDA Offering

PDA's seasoned specialists provide observations and recommendations structured to facilitate functionality-based clinical assessments and industry best-practices protocols that leverage return-to-work opportunities.

Consulting Module #9

Quality Review: Internal Clinical Resources


You probably have a good sense of how many clinical reviews are being completed, but do you really know whether the quality of the input is truly driving appropriate claim direction?


PDA Offering

PDA's seasoned specialists provide observations and recommendations structured to facilitate functionality-based clinical assessments and industry best-practices protocols that leverage return-to-work opportunities.

Outcomes

Develops the essential skills needed to complete functionality-based clinical reviews and provide high quality assessments that result in supportable claim decisions.

Promotes a holistic view of functionality that integrates objective clinical data and all appropriate information into a cohesive assessment of the credibility, consistency, and consensus of the evidence supporting the claimant’s reported functional capacity.

Reinforces the critical role of claims analyst by eliminating the tendency of clinical staff to “steer claims” and make “disability determinations.”

Facilitates a dialogue between clinical staff and management, which allows for a more objective way to provide constructive feedback.

Outcomes

Develops the essential skills needed to complete functionality-based clinical reviews and provide high quality assessments that result in supportable claim decisions.

Promotes a holistic view of functionality that integrates objective clinical data and all appropriate information into a cohesive assessment of the credibility, consistency, and consensus of the evidence supporting the claimant’s reported functional capacity.

Reinforces the critical role of claims analyst by eliminating the tendency of clinical staff to “steer claims” and make “disability determinations.”

Facilitates a dialogue between clinical staff and management, which allows for a more objective way to provide constructive feedback.

Duration

  • Referral Structure 
  • Clinical Review Adequacy 

Integrate PDA resource into customer’s quality review process

Duration

  •  Referral Structure 
  •  Clinical Review Adequacy

Integrate PDA resource into customer’s quality review process

For more information contact Mark Sawyer

(207)747-4308

Consulting Modules

#1
STD Claim
Management