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Utilization Management & Disability Reviews

Health plans, TPAs, delegated UM entities, providers, and employers needing oncology/heme expertise.

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  • Utilization Management & Disability Reviews
  • Overview

Core services

  • Oncology & hematology medical necessity determinations
  • Peer-to-peer preparation support (as applicable per contract)
  • Appeals (first-level and second-level clinical reviews)
  • MCG / InterQual / guideline-driven reviews (per client standards)
  • Oncology policy interpretation and pathway support
  • Disability / work capacity reviews (clinical analysis and documentation support, per contract scope)

What makes our UM work different

  • Clinically rigorous and defensible documentation
  • Fast turnaround and high consistency
  • Strong guideline literacy (NCCN-style logic, FDA label logic, CMS/LCD/NCD frameworks where applicable)
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