Utilization Review - InsurancePeer Review - Retrospective Retrospective Peer Review - involves the review of medical records after medical treatment has occurred. SFUR physician panelists assist health plans utilizing the health plan evidence-based criteria for delegated and non-delegated initial reviews, telephonic peer consultations, appeals for pre-service, concurrent Utilization Reviews and post-service requests for authorization of services, with the objective getting…

Utilization Review - InsurancePeer Review - Telephonic Peer Review - Telephonic SFUR physician panelists assist health plans utilizing the health plan evidence-based criteria for delegated and non-delegated initial reviews, telephonic peer consultations, appeals for pre-service, concurrent Utilization Reviews and post-service requests for authorization of services, with the objective getting closure on quality and necessity of care. SFUR has been providing…

Pre Authorization – Utilization Management covers 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 provide Utilization Review for Medicare Advantage plans and Medicaid plans.