Medical Consultants Network offers independent physician and related peer review services. Our services are utilized by over 600 organizations:

• Disability Carriers
• Workers Compensation Carriers
• Auto Liability Carriers
• Managed Care Plans
• Pre-Certification Organizations and/or Utilization Review Organizations
• Pharmacy Benefit Management Companies
• TPAs
• Group Health Insurers and ASOs
• Employers
  

Our panel of over 450 Board Certified physicians nationwide has assisted hundreds of our clients reduce medical costs while providing access to medically appropriate care.

MCN offers flexible, customized programs that seamlessly interact with your existing benefits administation programs, ensuring an expedient final product.  Because of MCN’s expanded network of over 20,000 providers, the breadth of physician specialties and subspecialties is unparalleled in the industry. We are able to provide reliable, evidence-based reviews for virtually any type of case.

Request a Review

Referrals can be received from authorized representatives via MCN’s client web portal, encrypted email, FTP upload or other secure method. The client portal is current in real time, so clients can track our progress at any point in the process, including accessing completed or archived reports. Once the review is completed, the report is automatically delivered to the client via the agreed-upon method.

Service Descriptions

Prospective Review - Utilization management conducted prior to a patient’s admission, stay, or other course of treatment (including outpatient procedures and services).  Sometimes called “precertification review” or “prior authorization.”

Retrospective Review - Utilization management conducted after services (including outpatient procedures and services) have been provided to the patient.

Concurrent Review - Utilization management conducted during a patient’s hospital stay or course of treatment (including outpatient procedures and services).  Sometimes called “continued stay review”.

Appeal - A written or verbal request by a consumer, ordering provider or prescriber to contest an organizational determination.

Peer-to-Peer Conversation - A request for additional review of a utilization management determination, performed by the reviewer from the original decision, based on submission of additional information or a peer-to-peer phone discussion.