Health Services
CMRG's Medical Department is lead by John A. Wells, MD, FACS. CMRG's in-house medical staff provides integrated, proactive medical intervention by providing guidance to plan participants throughout the span of the injury or illness.
Pre-certification, Concurrent Review and Retro Review allow for early identification of catastrophic cases that are referred to Large Case Management. Disease Management and oversight of the Patient First prescription drug program provides lifestyle changing information and motivation for those with chronic conditions to prevent costly and catastrophic complications.
With medical costs representing approximately 92% of the overall cost of healthcare benefits, CMRG's team of nurses and medical professionals work diligently to review your employee cases to assure quality care at the lowest possible cost. Acting as both patient advocates and employer proponents our medical team manages individual catastrophic large cases and individual long-term chronic diseases. The outcomes are better healthcare and lower costs for both employer and employee.
Our Health Services
Utilization review
Case management
Disease management
Wellness program
PPO Network Access
Out-of-Network negotiations
Pre-certification for in-patient and out-patient services
Hospital bill audit
Management reports
Appeal process
Peer review
Directed second surgical opinion
Employee communications
