Cost Containment SolutionsIndustry Partners Services Overview URAC Certified Cost Containment Solutions Medical utilization reviews, medical necessity and cost containment Learn More Industry Partners SFUR works closely with Cost Containment Services, Consulting and Technology Companies to extend the partner's offering to include Medical Necessity based Medical Cost Containment, Utilization and Compliance Services. Our strong Physician based review services through our 800+…
Who We ServeLegal & Audit Firms SFUR assists organizations like accounting firms, consulting firms and law firms, which can have both provider and insurance customers, with complex medical reviews, medical necessity assessments, medical management oversight and medical peer reviews. SFUR offers Cost Containment Services, Consulting and Technology Companies to extend the legal or audit firm team to include Medical Necessity…
Who We ServeAuto & Liability Insurance SFUR provides medical necessity based review services to auto & third party liability Insurance payers to optimize Medical Utilization Review & Management, Medical Cost Containment, and Medical Compliance, Fraud, Waste & Abuse. Our team of Certified Medical Audit Specialist and Professional Coders have successfully saved Payers customers millions in costs for reimbursements of hospital,…
Who We ServeHealth Insurance Companies SFUR services the health insurance market including insurance companies, third party administrators, worker compensation carriers, self-insured ERISA plans, health plans, health maintenance organizations (HMOs), general liability carriers, auto accident carriers, life insurance carriers including death and disability, managed Medicare plans, managed Medicaid plans, Medicare, Medicaid. Our clinical and business leadership brings decades of experience…
SFUR provides medical utilization professional services, applying medical practice and financial knowledge to improve our customers’ process, outcomes and financial results.
We service healthcare organizations across the country including physicians, physician practices, surgical centers, nursing homes, skilled nursing facilities, rehabilitation facilities, ancillary centers such diagnostic laboratories and imaging centers, hospitals, healthcare delivery systems and accountable care organizations.
Our URAC certified review services are provided through our physician panel of over 600 highest quality of practicing Physician Reviewers. Our medical experts span all medical specialties throughout the country.
Who We ServeWorkers Compensation Insurance SFUR provides medical necessity based review services to Workers Compensation Insurance payers to optimize Utilization Review & Management,, Medical Cost Containment, and Compliance, Fraud, Waste & Abuse. SFUR has been providing high quality Utilization and Peer Review Services for 30 years and is a member of the National Association of Independent Review Organizations (NAIRO). We…
SFUR offers predictive software (through one of our trading partners) that list those charts requiring review that have the highest probability of documentation error. Once these charts our identified, our physicians review the charts, and the results generate a 4:1 gross return on investment for our hospital customers.
The medical Utilization Review/Utilization Management (UR/UM) component for Medicare Advantage, Managed Medicaid and other managed care plans is a critical function that requires medical depth, breadth and resourcefulness. Members of SFUR’s physician panel have been providing Utilization Review for Medicare Advantage plans in thirty-two states for over ten years.
SFUR is committed to improving the healthcare ecosystem. Both healthcare delivery participants and those entities that pay for healthcare, leverage the knowledge of the SFUR’s physician panelists. Monitoring compliance, fraud, waste and abuse starts with the SFUR physician panelists that can be impartial, objective and current in the knowledge and practice of their respective specialty.
SFUR defines medical cost containment as the process of leveraging medical and business knowledge to potentially lower the cost of medical bills.
We provide review, assessment and negotiation of medical cost, using a variety of methods which include, Separation of Charges, Coding Validation, Medical Necessity, State & Payer Specific Rules and Reasonable Charge Analysis.