Eliminate inappropriate pay-outs with the fastest reports
in the industry
MediCor is the medical cost containment service that combines personal support, custom strategy and intuitive technical expertise to save time and money in the bill review process. Our qualified Clinical Pharmacists review each patient’s prescription history and medication regimen to extract a detailed retrospective data review report. Clients are given the option of requesting contact with the prescribing physician, and each review is accompanied by a full-disclosure Medical Bill Review report at-a-glance, supported by evidence-based pharmaceutical resources.
Accurate, complete information has always been the name of the game in cost containment. MediCor’s comprehensive clinical pharmacy Drug Utilization Review generates report turn around in as little as 10 days – half the time it takes most medical review services.
Who We Serve
MediCor’s DUR-Rx program is the gatekeeper service for your Group Health, Worker’s Comp and Auto Liability/No Fault claims.
The MediCorDUR-Rx Process
We combine industry specific, high-tech data resources with deep-level due diligence review, including expert input from Clinical Pharmacists and the option of seeking consultation from the prescribing physician. Reviews performed by our clinical pharmacists include full medical chart reviews and determinations on drug interactions, generic availability, duplication of therapy and formulary requirements. A comprehensive report, supported by evidence-based medicine, is then sent to the client upon completion.
DUR-Rx At Two Service Levels
#1 Standard Review -Standard, or “Desk Top” Review is for new patients who are taking five or fewer medications, or a short-term patient who has not been diagnosed, or suffers from chronic illness. Reviews include screening for drug interactions, determination of generic availability, check for duplication of therapy and determination of formulary requirements.
Who qualifies for a Standard or Desk Top Review?
- All new patients.
- Patients taking five or fewer medications.
- Short-term patients who have not been diagnosed or suffer from chronic illnesses.
What documents are required?
- Completed health and history review form
- Completed patient information form
- Completed personal medication record that includes dosage, prescribing physicians name, purpose/intent of medication, frequency, start date and end date if applicable
- Copy of full patient chart
#2 Comprehensive Review - Comprehensive DUR Review is the best option for higher volume patients with a deeper medical history who have been prescribed six or more drugs. Our clinical pharmacists conduct a full medical chart review, check for drug interactions, determine generic availability, check for duplication of therapy and determine formulary requirements. As needed, services can also include a discussion with the prescribing physician about medical appropriateness of the prescribed regimen. If the prescribing physician declines, our clinical pharmacists will document their attempts to contact the physician. A comprehensive report, supported by evidence based medicine, will be prepared and sent to the client upon completion.
Who qualifies for a Comprehensive Review?
- Patients with any Mental Health conditions ( i.e. depression)
- Patients who are prescribed multiple drugs of six or more
- Patients who require treatment six months or longer
- Patients diagnosed with multiple chronic illnesses
- Patients who suffer from any of the following illnesses: diabetes, hypertension, lipid disorder, COPD (chronic obstructive pulmonary disease).
- Patients with chronic illness or illnesses that are 65 or older
What documents are required?
- Completed health and history review form
- Completed patient information form
- Completed personal medication record that includes dosage, prescribing physicians name, purpose/intent of medication, frequency, start date and end date if applicable
- Copy of full patient chart
DUR-Rx Medical Cost Containment Benefits
MediCor’s unique real-time collaboration between the physician, pharmacist and our staff is a dynamic powerhouse for medical cost containment in one flexible, time-efficient process that quickly determines medical necessity and accuracy. MediCor’s line-item, compliance-specific medical cost containment services are crowned by truly personal customer service. DUR-Rx is arguably one of the insurance industry’s highest performing platforms for medical cost containment services. Those kinds of results can only happen way beyond filling out a form. You’ll know us by name. It’s just one more reason why our DUR process has earned us a reputation as the bill review company most often referred by risk managers in Georgia and the nation for medical bill review and audit process services.
More personal contact. More process options. More regimen choices.
- Comprehensive – option of consultation from specialists prescribing physician and pharmacist
- Fast—four times out of five, MediCor is twice as fast as competitors, completing final reports
within 10 business days - Competitively priced as our clients attest
Line item report by MediCor Team (Staff, Clinical Pharmacist, Physician) provides critical facts as well as expert opinions that become your platform for effective change:
- Medication dosage
- Potential interaction amongst current regimen
- Other potential drug therapy concerns
- Appropriateness of the drug regimen for the diagnosis and potential compensation
- Long-term pharmacological effects of the current medicine regimen
- Patient compliance when using medication
- Patient prescription history
- Better, more cost-effective alternatives to current regimen
- When applicable, consultation advice from prescribing physician
In Medical Bill Review Processing, Knowledge is Power
MediCor can help you create cost-effective alternatives to the patient’s current regimen. When you know the facts, that’s real power for eliminating costly, inappropriate pharmaceutical prescriptions, enabling higher efficiencies and gaining stronger control over managed care claims in your medical cost containment program. MediCor’s comprehensive clinical pharmacy Drug Utilization Review process brings medical bill audits to higher levels of data reporting and cost control than ever before possible, for enhanced bill review services you can bank on.
MediCor…Client Friendly, Payor Satisfaction, to the Core
