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Overview

Independent Medical Examinations

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Workers' Compensation

Medicare Compliance

Case Management

Portfolio of Services
     
 


ExamWorks Service Portfolio

ExamWorks provides a portfolio of Independent Medical Examination and Review Services for a wide range of insurance lines including bodily injury, automobile, workers' compensation, disability and federal insurance programs. Our service portfolio includes Independent Medical Examinations (IME), Peer Reviews and Bill Review Services. Evidence-based medical findings, objectivity and customized service are fundamental elements in all of our services.

Our clients utilize independent review services to evaluate health care claims for accuracy and legitimacy. The ExamWorks service portfolio responds to the urgent claims evaluation needs of our clients including the identification of unnecessary services, inappropriate charges, misrepresentations and abuse. We share a common vision: effective, thorough and independent medical review.

Our goal is to facilitate medical cost containment while upholding the professional and fiscal integrity of health care services. Our understanding of the varied needs of the participants is embedded in our customer-focused culture. We work closely with clients to develop customized service offerings and processes that meet a specific need, corporate requirements and regulations.

Secure Portal

Submit IME and Peer Review referrals using our secure web portal. Track referrals in real time, check appointment status, search for a physician, upload medical records and download the final reports 24/7. Enjoy all the benefits and efficiencies of automated workflow management while our service professionals attend to all the details. Ensure protection of patient health information and company data. Try quick referral for your first service request. Once you have tried it we are sure that the security, benefits and ease of use will encourage you to register. Contact us to learn more and get registered.

Audits and Accreditations


AT 101 SOC 2 Trust Service Principles

The AT 101 SOC 2 Type 2 audit is performed in accordance with the Trust Services Principles, testing and reporting on the design (Type I) and operating (Type II) effectiveness of a service organization's controls. The SOC 2 Trust Service Principles focus on four areas: policies, communications, procedures and monitoring. The SOC 2 report focuses on a business's non-financial reporting controls as they relate to security, availability, processing integrity, confidentiality, and privacy of a system. Each of the principles has defined criteria controls that must be met to demonstrate adherence to the principles.

ExamWorks pioneered the application of Virtual Private Cloud Computing Network and Platform as a Service in the IME industry, manages and maintains its data centers and is the first IME company to be audited to this rigorous security standard.

When outsourcing critical company functions to a service organization that include patient health and company confidential information, ExamWorks' successful completion of the AT 101 SOC 2 Type 2 audit provides tier one assurance that all functions are performing to the highest operational standards. Audits in accordance with the AICPA standards complement ExamWorks' best practices management.

ExamWorks' current SOC 2 audit certificate is posted below. The audit is retrospective, and reflects the previous year which is the audit period.

ExamWorks AT 101 SOC 2 Type 2 Audit Certificate PDF PDF

AICPA


URAC Core

ExamWorks has received URAC Core accreditation for IME services. URAC offers a wide range of quality benchmarking programs.  Achievement of Core accreditation demonstrates that ExamWorks is dedicated to meeting the highest standards of quality in the industry. In addition to the initial rigorous preparation required for the accreditation process, URAC reviewers monitor company service centers randomly at any time.

Core accreditation standards address several key organizational functions that are specific to peer review services and are important for any health care organization, including: organizational structure; staff qualifications; training and management; regulatory compliance, oversight of delegated activities; quality management; customer satisfaction and consumer protection. ExamWorks’ achievement of Core accreditation provides payors, examinees, providers, purchasers, regulators and employers assurances that our practices are quality-focused and fair and equitable for all parties.

ExamWorks was first accredited for Core in 2011.


URAC CORE

 





 
 
     
       
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