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Understanding the Utilization Review & IMR Process

We’ve listed these videos in order as they might occur on a typical claim, though no two claims are exactly alike. If your adjuster hasn't invited you to watch these videos, you can contact your adjuster for the viewing sequence that best matches your unique situation.

Utilization Review simply ensures the treatment prescribed by your treating doctor is necessary and appropriate for your injury. Medical treatment requests can be authorized, modified, or denied. If a treatment request is modified or denied and you disagree, you and your doctor have a couple of options. Your doctor can request a second review and provide additional information or you can request an Independent Medical Review (IMR), where the treatment request is reviewed by an independent panel of medical professionals. Watch this video to learn more.

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