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866.532.1929
www.novarenetwork.com

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Review the medical.

Restore the employee.

Renew productivity.

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Utilization Review

Based on reliable science, Novare improves outcomes for the injured worker and lowers costs for the employer, while promoting an environment conducive to the well-being of the injured worker.

  • Pre-Certification/Pre-Authorization
  • Retrospective Review
  • Physician Peer Review
  • Impairment rating review
  • Drug Utilization Review
  • Early Compensability Analysis
  • Independent Medical Exams

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Medical Bill Review

In order to minimize medical exposure and lower medical costs for the life of a claim file, Novare utilizes automated bill review software and other solutions which ensure maximum reductions for authorized payments on provider
services.

  • Workers Compensation State Fee Schedule and U&C Reductions
  • Negotiated agreements / Pre & Post Negotiation
  • Specialty Bill Review: Rehabilitation, Hospitalization LT, limb prosthetics, High Dollar DME, Long Term Care
  • PPO, Specialty Networks
  • Liability cost analysis reviews

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Case Management

Based on reliable science, Novare improves outcomes for the injured worker and lowers costs for the employer, while promoting an environment conducive to the well-being of the injured worker.

  • Medical Field Case Management
  • Telephonic Case Management
  • Vocational Case Management
  • Medical cost Projections

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Please allow our experienced, professional staff to assist you with any additional questions you may have regarding our diversified service offerings.

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Medicare Set-Asides

Novare ensures that clients comply with The Centers for Medicare and Medicaid Services (CMS) guidelines. MSAs are the vehicles designated by CMS to be used when settling claims as a “safe harbor” that demonstrates Medicare’s interest was taken in to account in the settlement process. Pursuant to 42 U.S.C. §1395y(b)(2) and § 1862(b)(2)(A)(ii) of the Social Security Act, Medicare is precluded from paying for a beneficiary’s medical expenses when payment has been made or can reasonably be expected to be made under a workers’ compensation plan, an automobile or liability insurance policy or plan (including a self-insured plan), or under no-fault insurance. Novare assists in your MSA efforts by providing the following services:

  • Verification of: SSD / Medicare Status / Lien Status
  • Medicare Lien Negotiation
  • Worker’s Compensation Medicare Set- Aside
  • Liability Medicare Set- Aside
  • Submission of MSA to CMS
  • Medical Cost Projections
  • Drug Utilization Review
  • Life Care Plans

Novare Address Info

306 Pine Street
Suite 100
Madisonville, LA 70447
985.845.4548 t • 985.845.9913 f

5850 Town & Country Blvd.
Suite 1101
Frisco, TX 75034
888.705.1070 t • 888.667.9572 f

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