MCMC knows that Utilization Review is an effective tool in managing medical services, utilization and costs.

MCMC’s Utilization Review team includes an experienced staff of Registered Nurses, Physicians, Medical Directors, and large panel of Certified Peer Reviewers.  The team uses recognized guidelines and treatment protocols to determine if a claimant’s medical care and treatment was reasonable and necessary.  When the team conducts the review, if the treatment was appropriate, the Utilization Review nurse certifies the treatment.  If the Utilization review nurse cannot certify the treatment, the claim will be referred to MCMC’s Peer Review panel.