Utilization Review

MCC has adopted a streamline approach to UR that is systematically designed to alert to the possibility of excess claims.

Pre-Certification Process

Determines medical necessity.

Concurrent Review

Continuing collection of clinical data to support continued services.

Retrospective Review

Determines medical necessity after services have been rendered.

MCC utilizes MCC Guidelines as its clinical guidelines when performing reviews.

Our Medical Director provides oversight of all clinical programs including utilization management. He performs medical reviews and pre-determinations as needed on a daily basis. As the medical director, he is the sole person at MCC that can deny services for medical necessity. He works with the Vice President of Clinical and Client Services on medical necessity criteria, appeals, and continuing education.

Internal Medicine

Oncology/Hematology

Orthopedics

Urology

Neurology

Cardiology

Surgery—General

Surgery—Vascular

Obstetrics

Gynecology

Pulmonology

Oral/Maxillofacial Surgery

Dental

Plastic Surgery

Pain Management

Otolaryngology

Anesthesiology

Pathology

Radiology

Ophthalmology

Allergy

Immunology

  INTAKE FORM

Please take a look at and download our intake form if you would like to discuss our services. All information is confidential and legally privileged and is intended only for the use of individuals listed in the application.

About Us

We provide full support

MCC believes that by combining the efforts of your unique situation with the services of Managed Care Concepts in a fully integrated system of care, health plan benefits can be optimized, dollars can be conserved and student /employer benefits can be managed more effectively.

The corporate office is located in Orange, Texas. However, our innovative platform allows us to actively address the needs of our clients on a global platform.

Contact us today and see the MCC difference.

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Serving areas nationwide

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