We provide medical necessity and appropriateness of care review and consultation for select clients that include:
- 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
Our expert doctor panel and staff are able to assist with many different independent review services you may need, including:
- Medical Necessity and Appropriateness Peer Review – Board-certified psychiatrists are available twenty-four hours a day to provide:
- Pre-certification review
- Concurrent review
- Standard and expedited appeals
- Retrospective medical record review
- Experimental/investigational review
- Psychological/neuropsychological testing review by psychologists
- Clinical Case Shaping and Consultation – Prest psychiatrists are specialists in the review of complex behavioral health cases requiring in-depth assessment, shaping, and ongoing consultation. This service goes beyond medical necessity review, providing an evidence-based approach to the most severe psychiatric illnesses, and aiding health care plans in all aspects of behavioral health disease management.
- Behavioral Pharmacy Review – Prest psychiatrists are specialists in psychopharmacology consultation, appropriateness of care opinions, and nationally recognized prescription standards. Services include concurrent medication review, retrospective prescription review, and physician prescribing practice consultation.
- Disability Review – Prest & Associates understand employers want to have their employees return to work as quickly as possible, but not prematurely. Independent review helps facilitate our clients’ goals. To help our clients meet their goals, Prest & Associates will deliver a report that:
- Clearly and concisely assists the client with a timely psychiatric opinion;
- Ensures the patient is receiving appropriate psychiatric and addiction medicine treatment; and
- Identifies earliest possible realistic return to work.
- State-Level Appeal Review – Patient protection legislation in many states allows insured individuals to challenge adverse medical determinations made by their health plans.
- Psychological / Neuropsychological Testing
- Expert Witness / Judicial Hearings
- Special Projects – Prest & Associates is available for special projects.
Contact us to learn more about the services we can offer.
More about our services
We currently provide independent review and consultation services to over 100 clients throughout the United States, including a number of the country’s largest fully insured health plans, managed behavioral healthcare organizations (MBHOs), and managed Medicaid providers. We are certified and/or qualified to provide state level appeal review in 19 states.
- Managed care organizations
- Insurance companies
- Health plans
- Governmental agencies
- Claims administrators
Here are a few ways Prest & Associates, LLC keeps your data safe:
- Protected Health Information is stored in a SAS 70 Type II/SSAE 16 compliant data center, one of the highest security standards available today.
- All Prest information technology hardware is securely destroyed by a certified equipment retirement company.
- Connections to the Prest Secure Web Portal are encrypted up to 256-bit TLS 1.2 encryption.
- Prest assets are subjected to routine vulnerability and penetration testing.
- Prest staff and reviewers are trained on methods of handling sensitive data and regularly updated on events affecting online security and health care technology.
- Prest reviewers and other business associates are regularly audited for HIPAA compliance
Prest & Associates, LLC delivers the reports you need, when you need them. We meet URAC standards for timeliness, and in some cases can have reports back to you in less than an hour.
Our doctors are on call 24 hours a day, 7 days a week, weekends, and holidays to assist with your Independent Review needs.