WHAT NOW WITH UTILIZATION REVIEW AND IMR?

"Utilization Review"(UR) is the first process in denying medical to the injured worker.  The insurance basically uses this process to deny medical care-especially expensive medical care in Workers' Compensation cases most notably home care and assistance. Once there has been a "denial" of care to the injured worker, there is…

INSURANCE COMMISSIONER WARNS CALIFORNIA INSURANCE PROVIDERS AGAINST THE PRETEXTUAL DENIAL OF PREVIOUSLY APPROVED HOME CARE.

Investigations by Pro Publica and NPR have uncovered the abrupt claim denials of continuing home care, leaving a paralyzed injured worker without a home health aide with no alternative but to sit in his own waste for hours. The Senate Labor and Industrial Committee was to undertake a Hearing on…