Services
Medical Necessity and Appropriateness Peer Review
- Precertification
- Concurrent
- Retrospective
- Appeals
- External Appeals
- Peer to peer consults
Clinical Case Shaping and Consultation
- Pharmacy review
- Disability review
- State Appeal
- Psychological/Neuropsychological testing
- Applied Behavior Analysis (ABA) review
- Expert Witness/Judicial Hearings
- Special Investigation/Fraud, Waste, and Abuse
- Disability review
Special Projects
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 Rockford, IL
- 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:
Contact us to learn more about the services we can offer.
More about our services
INDUSTRIES WE SERVE
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
- Attorneys
PRIVACY AND SECURITY
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
FAST TURNAROUND
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.