Utilization management of workers' compensation: outpatient physical therapy.
Workers' compensation insurance carriers are becoming aware of the potentially high cost of physical therapy. Utilization management of outpatient physical therapy by means of a precertification process is a relatively new development in workers' compensation. Physical therapy treatment plans are reviewed by peers to ensure that proposed care is appropriate and cost-effective and that past care has resulted in measurable, objective, functional progress. Treatment plans are thus either certified or noncertified, or changes are negotiated. Ongoing care is monitored to facilitate the patient's progress through appropriate phases of physical therapy toward "maximum medical improvement."
Zitzmann
S L
SL
Focus Healthcare Management, Brentwood, TN.
D000553:Ambulatory Care / Q000592:standards; D003363:Cost Control / Q000379:methods; D006801:Humans; D026741:Physical Therapy Modalities / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States; D014600:Utilization Review / Q000458:organization & administration*; D014942:Workers' Compensation / Q000191:economics*