Risico Total Managed Care

Providing employers with customized programs and services that promote optimal outcomes related to disability management and medical cost containment.

Risico Total Managed Care offers an integrated and focused approach to Managed Care. We provide our clients with customized cost containment strategies and programs that are designed to maximize the client’s return on investment, ensuring injured employees receive appropriate treatment, expedited and sustained recovery, and a safe return to work.

Risico Managed Care Services

Managed Care Services

  • Nurse Case Management -Telephonic and Field (task and full assignments)
  • Utilization Review
  • Medication Prescription Review/Management

Early and Focused Intervention Services

  • First Point of Injury Triage
  • Early Intervention Program
  • Focused Intervention on Legacy, or Future Medical Claims 

Bill Review and MPN/PPO Services

  • Bill Review
  • Complex Bill Review
  • Hospital/Inpatient Bill Review Auditing
  • Hospital/Outpatient Bill Review Auditing
  • Negotiations for Non-Fee Schedule Bills
  • Usual and Customary Reviews
  • Pre-Medical Service Cost Negotiation

MPN/PPO Services

  • MPN and PPO Management
  • MPN/PPO Provider Credentialing
  • Channeling  Injured Workers to Approved Provider PPO Vendors
  • Medical Imaging, CT and Bone Scans Preferred Provider Management
  • Durable Medical Equipment Preferred Provider Management
  • Pharmacy Benefit Management