Utilization Review

Reasonable and Necessary Treatment

By |2017-02-04T16:45:36-06:00February 4th, 2017|Medical Benefits|

Injured workers with compensable Illinois workers' compensation claims are entitled to reasonable and necessary medical treatment. The Illinois Workers' Compensation Act provides: The employer shall provide and pay ... for all the necessary first aid, medical and surgical services, and all necessary medical, surgical and hospital services thereafter incurred, limited, however, to that which is reasonably required

Utilization Review

By |2017-02-06T22:35:05-06:00February 1st, 2017|Medical Benefits|

Employers and insurance companies can evaluate the medical necessity of proposed or previously provided medical treatment with a process called utilization review ("UR"). Section 8.7 of the Illinois Workers' Compensation Act governs the use of utilization review, which it defines as: the evaluation of proposed or provided health care services to determine the appropriateness of