(800) 294-0508
Tel : (305) 667-4890Fax : (305) 667-6242
Welcome to SFUR

SFUR is a Medical Cost Containment and URAC Certified Medical Independent Review Organization

We are a URAC accredited Independent Review Organization (IRO) providing Utilization Review/Management (UR/UM), Peer Review, Medical Cost Containment, Expert Medical Witness, Physician Reads, and Compliance, Fraud Waste & Abuse services to various members of the healthcare ecosystem.

SFUR is a physician driven organization offering services of every medical specialty through a panel of 600 board certified physicians.

On the medical cost containment end of our business, we have reviewed and negotiated thousands of medical bills resulting in savings 70% of the time to our payer customers. Our results speak for themselves. Typically, if our payer customers pay a fixed fee for our services, they will generate a 400% return on investment because of the savings we generate. If our payer customers opt for percent of savings model, where SFUR only gets paid if savings are generated, the return on investment is over 1,500% to our payer customers.

On the UR/UM and Peer Review end of our business, we have handled thousands of cases for both the healthcare provider and payer community.
Its all about

Service

PROFESSIONAL TIMELY CUSTOMER SERVICE
It’s been our privilege supporting customers across the US for over 25 years.  We continually strive to improve and innovate our services to best meet our customers’ ongoing challenges.

ACCURATE AND CONSISTENT WORK PRODUCT DELIVERY
We are committed to the highest quality work product and aspire to exceed our industry’s URAC and CPC Certification requirements.

BEST PRICE, HIGHEST VALUE
We are confident that we provide our customers the best price with the highest quality results of all Certified Utilization Review Companies.

Medical Cost Containment

With Results

LEVERAGING MEDICAL KNOWLEDGE
Our goals are to provide Medical Utilization Professional Services, applying medical practice and financial knowledge to improve our customers’ process, outcomes and financial results.

REDUCE COSTS FOR WORKERS’ COMPENSATION CARRIERS
We are a leader in providing Workers Compensation Claims Review, Bill Negotiation and Insurance Peer Review applying medical knowledge and financial best practices to benefit our customers.

IMPROVE PATIENT TREATMENT OUTCOMES FOR HOSPITALS
Our team of Certified Physician Specialists are an extension of our customers’ quality assurance and compliance requirements to help to continuously improve medical outcomes.

Medical Cost Containment

Payer Services

Medical Knowledge
Our goals are to provide Medical Utilization Professional Services, applying medical practice and financial knowledge to improve our customers’ process, outcomes and financial results.

REDUCE COSTS FOR WORKERS’ COMPENSATION CARRIERS
We are a leader in providing Workers Compensation Claims Review, Bill Negotiation and Insurance Peer Review applying medical knowledge and financial best practices to benefit our customers.

IMPROVE PATIENT TREATMENT OUTCOMES FOR HOSPITALS
Our team of Certified Physician Specialists are an extension of our customers’ quality assurance and compliance requirements to help to continuously improve medical outcomes.

Cost Containment & Improved Outcomes

Provider Services

PRACTICING PHYSICIANS ACROSS ALL MEDICAL SPECIALTIES 
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).   Our Panel includes all specialties in all States.

URAC CERTIFIED TEAM AND REVIEW PROCESS
SFUR’s board certified, URAC compliant Physicians provide any kind of form driven second read, including radiology, pathology, interventional cardiology, and other special studies. Third read tie-breaker available for discrepant findings.

BEST IRO REVIEW SERVICES AT THE BEST PRICE 
SFUR is a proven and affordable source of 3rd party over-reads with ten years of history servicing hospitals nationwide.  We are confident that we provide our customers the best price with the highest quality results of all Certified Utilization Review Companies.

Who We Serve

Utilization Review, Fraud Waste & Abuse, Physician Review Services

Healthcare Providers

SFUR provides medical utilization professional services, applying medical practice and financial knowledge to improve our customers' process, outcomes and financial results.

We provide URAC certified review services through our physician panel of over 600 highest quality of practicing Physician Reviewers. Our physicians cover all medical specialties throughout the country.
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Utilization Review, Medical Cost Containment, Fraud Waste & Abuse, Utilization Review

Workers Comp Insurance

SFUR provides workers compensation medical cost containment and medical review services to 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.
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Medical Cost Containment, Fraud Waste & Abuse

Insurance Companies

SFUR provides medical necessity based review services to Insurance payers to optimize Utilization Review & Management,, Medical Cost Containment, and Compliance, Fraud, Waste & Abuse.

With our medical necessary based reviews, SFUR has negotiated Millions in savings in payments of medical bills for Payers across the country.
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Cost Containment, Bill Review & Negotiation, MSPA & DRG Reviews

Health Insurance

The insurance market place includes 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.
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Medical utilization reviews, medical necessity and cost containment

Legal Firms

Organizations like accounting firms, consulting firms and law firms which can have both provider and insurance customers are also serviced by SFUR.

SFUR’s physician panel is the perfect complement to for these accounting, consulting and law firms to assist in reviews of Cost Containment and Fraud, Compliance and Abuse.
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Medical utilization reviews, medical necessity and cost containment

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+ Physician panel covers every medical specialty and geographic requirement.
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What We Do

What We Do

Compliance Fraud Waste Abuse Services

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 is impartial, objective and current in the knowledge and practice of their respective specialty.
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What We Do

Medical Cost Containment Services

SFUR defines medical cost containment as the process of leveraging medical and business knowledge to potentially lower the cost of medical bills based.

This includes reviews and medical based analysis on Separation of Charges, Coding Validation, Medical Necessity, State & Payer Specific Rules, Reasonable Charge Analysis.
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What We Do

Insurance Utilization Review

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.
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What We Do

SFUR Physician Services

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.

This process address discrepancies between hospital coders and attending physicians. The reviewing physicians will review hospital charts before hospital bills are generated. The result is an increase in documentation accuracy and specificity. There isn’t any software to install since this is a chart reviewing process
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What We Do

Workers Compensation Utilization Review

Utilization Review manages medical aspects of claims in conjunction with ensuring injured workers are provided with timely and appropriate medical care.

Over utilization of medical treatment is a driving factor in the overall cost of a Workers’ Compensation claim. SFUR, through the use of licensed nurses, board certified physicians and application of data driven evidence-based guidelines, addresses costs through a proactive approach.
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What We Do

Healthcare Provider Utilization Review

Even though payers deploy strategies to control physician office and hospital services, hospitals utilize utilization review and management to ensure the optimum use of the facility’s resources and high-quality care.

As value-based reimbursement models become more prevalent, hospital utilization management will take on a more important role. SFUR provides prospective, concurrent, and retrospective utilization review in the provider community.
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Our Happy Clients

What Our clients Say

SFUR Customer

SFUR Customer

Chief Financial Officer

SFUR Team reviews have resulted in  “Amazing Savings”  for our company.

SFUR Customer

SFUR Customer

Chief Quality Officer

SFUR has an impressive team on their Physician Reviewer Panel, basically any specialty knowledge is available as needed. “Its an Answer to my Prayers”

SFUR Customer

SFUR Customer

SVP Cost Containment

As a Self Insured Employer  SFUR is a valued member of our Workers Compensation Cost Containment strategy. “Nobody is applying clinical and Negotiation skills like SFUR”

SFUR Customers

SFUR Customers

SVP Risk Management

SFUR has been a key strategic partner in our Medicare Cost Containment business.    With the recommendations of our Risk Management group, we engaged SFUR to augment our Medical Cost Containment as well as  Compliance, Fraud, Waste & Abuse Programs, with really great outcomes.