Prest Story

Prest & Associates, LLC (Prest) is the oldest and one of the largest independent review organizations specializing in psychiatry, addiction medicine, and behavioral healthcare. Susan R. Prest, M.A., and James Richard Prest, M.D., founded the company in 1991 to apply their vast administrative and clinical experience to improve quality of care and protect patients’ rights through the independent review process.

We provide medical necessity and appropriateness of care review and consultation for select clients that includes:

  • Immediate access to board-certified, credentialed psychiatrists 
  • 24-hour service and timely report processing
  • Courteous and efficient administrative staff based in Madison, WI
  • Compliance with all state and federal mandates and industry standards
  • Meets HIPAA and NIST 800-53 standards for IT Compliance

Prest is URAC accredited as an Independent Review Organization, an indicator of its commitment to quality and accountability within the independent review space.


Key Personnel


James Richard Prest, M.D. (1922-2006)
Chairman of the Board / Chief Medical Officer

Dr. Prest co-founded Prest & Associates, LLC in 1991. He was board certified in psychiatry with extensive experience in consultation to managed care, psychiatric administration, the treatment of hospitalized adolescents and adults, and private practice in general psychiatry and psychoanalysis.

Barbara Center

Barbara Center, M.D.
Medical Director

Dr. Center is a board certified psychiatrist with subspecialty board certification in Child and Adolescent Psychiatry and Addiction Medicine. She is also an Assistant Clinical Professor in the Department of Psychiatry at the University of Wisconsin. She has extensive experience in psychiatric administration, providing psychiatric evaluation and treatment of children, adolescents, adults and geriatric patients in outpatient, partial hospital, and inpatient settings.

Judith C. Shaffer

Judith C. Shaffer
General Manager

Judith Shaffer has been managing, teaching and training people in a variety of professional settings for more than 20 years. She holds a Master of Science degree from the Indiana University School of Education and has experience working both in the United States and abroad. She is fluent in English, Spanish and French. Responsibilities include keeping the company running efficiently by directing and coordinating personnel and overseeing the independent review process.


Prest & Associates is proud to be accredited by URAC.

URAC, an independent, nonprofit organization, is a well-known leader in promoting healthcare quality through accreditation, education, and measurement programs. Its accreditation program helps ensure that organizations that perform IRO services: are free from conflicts of interest; establish qualifications for physician reviewers; address medical necessity and experimental treatment issues; and have reasonable time periods for standard and expedited reviews and appeals processes. URAC accreditation is a symbol of excellence for organizations to demonstrate their commitment to quality and accountability.