Utilization Review
In accordance with Massachusetts General Law M.G.L.c.152 Sargent & Associates’ utilization review program, Sargent Medical Review, has been an approved vendor since 1998. All of the reviewers are registered nurses and have completed the CPUR certification program administered by Interqual, a recognized national leader in Utilization Review. They are required to obtain continuing education credits for their CPUR designation on an ongoing basis. The reviewers utilize the Massachusetts guidelines and criteria adopted by the Health Care Services Board (HCSB) of the MA Department of Industrial Accidents. When they are not applicable, guidelines and criteria are utilized from other sources, i.e., The Medical Treatment and Protocols of the State of Rhode Island. The Medical Director, Dr. Richard Zimon, is a member of the Health Care Services Board (HCSB) of the DIA. He oversees the assurance of the program, keeps abreast of the regulation changes, writes internal guidelines, provides first level reviews and provides in-service to the UR staff. For the past seven years Sargent Medical Review has been in good standing with the DIA and has had no violations imposed on them.