Medical Case Management
TRISTAR Case Management is defined
as the establishment and
coordination of a treatment plan
that is medically appropriate and to
enforce the application of the
treatment plan through our Bill
Review component. We are committed
to improving the quality of care and
controlling costs while managing
treatment to ensure optimum
outcomes.
TMC is able to provide our clients
with medical case managers in order
to maintain contact with employees,
doctors, claims professionals to
control medical utilization, obtain
enhanced injured employee compliance
with optimal treatment protocols,
and expedite return to work.
Case Management consists of the
following services:
Utilization
Review
Early Intervention/Telephonic
Case Management
Field Case Management
Peer Review
To learn more about TRISTAR Medical
Case Management click here.
Medical Bill Review
TRISTAR Managed Care (TMC) provides
medical bill review services, access
to local and regional PPO Networks
and Medical Case Management. TMC’s
managed care program can, by our
estimate, effectively reduce the
current medical losses at least 10%
above industry benchmarks because of
TMC’s high level bill review,
BillChek and superior PPO discounts.
To learn more about TRISTAR Medical
Bill Review click here
Network or PPO Access
TRISTAR accesses various networks
and has the ability to develop a
network for our clients that serve
to drive higher penetration rates
and higher savings. Many of our
inpatient facilities have HMO
discounts that are the deepest
discounts available. In addition to
a national network of medical
providers and facilities, TRISTAR
provides access to a Durable Medical
Equipment, Radiology, and Pharmacy
Network. Our networks may be
accessed via the Internet, and
information regarding providers can
be given to the client members. Bill
Review and PPO Network Access
reports are given to the client that
demonstrate to the client the billed
charges, fee schedule reductions,
PPO Discounts, penetration and
utilization statistics.
To learn more about TRISTAR
Network or PPO Access click here.
