MCC has adopted a streamline approach to UR that is systematically designed to alert to the possibility of excess claims.
Determines medical necessity.
Continuing collection of clinical data to support continued services.
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
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.
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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