Marquee is a leading cost containment organization that offers knowledge of the managed care industry and a sincere dedication to improving outcomes for all involved. Not only do we provide early intervention, medical treatment plans and return-to-work programs, we also offer complete bill review and PPO network savings. These strategies all work together for the good of injured employees, while also having a positive effect on your risk management program.

Our medical cost containment is based on a simple formula. We combine state-of-the-art software, professional expertise and a national PPO network built for the casualty market. Each cost containment innovation offers employers improved return-to-work outcomes and industry leading savings that are unsurpassed in the marketplace.

Cost Containment

• National and regional PPO management
• Negotiation unit
• Compounded/narcotics medication review/management
• Utilization review
• Peer review services
• Clinical prescription reviews
• Telephonic case management
• Early Return to Work

Marquee Managed Care offers an integrated approach to solving the many intricate managed care needs in the California Workers’ Compensation arena. One of our key advantages is that Marquee Managed Care nurses and bill reviewers work on the same system platforms. This integration allows direct access between the nursing and bill review teams should questions arise regarding authorization or appropriateness of medical treatment. This integration also allows all parties involved to have real-time access to medical reports, correspondence and claim documentation for accurate authorization of treatment and precise payment of authorized care.

Medical differentiators

Unlike most Utilization Review entities, our Medical Director is readily available to the nurses and staff with one touch of a button. He provides didactic updates, which enable the caller to fully understand complex or multiple issues, further enhancing claims handling. Our nursing staff is highly trained to provide skilled assessment and case management of your claims. We put our resources to work for you by keeping our medical team lean and ready to work.

Contracts and vendor agreements

• Multiple PPO Networks available
• Multiple MPN Networks available
• Ancillary Vendor Contracts
• Acupuncture
• Chiropractic
• Durable Medical Equipment
• Home Health
• Pharmacy
• Physical Therapy
• Transportation
• Translation

Vendor partnerships for:

• Drug screens
• Life care plans
• Medicare set-aside

Marquee’s flexible technology plays a critical role in minimizing costs, ensuring patients’ access to the information they need. Our technology team works with a variety of vendors who assist our efforts in providing clients with the most seamless work experience possible.

Vendor partnerships for:

• Claims software integration allows us to create data feeds for your system in a format you need, which allows for the easy sharing of information in a flexible platform.
• Paperless case management system has an electronic data interface that allows interoperability with all major claims management systems.
• Sophisticated business rules engine means we can write custom rules and process bills how the client requests them. We can notify clients once any action is taken on a bill and provide any level of detail.
• Duplicate bill checks and state reporting. We can regurgitate the information in an electronic format required by the state.
• Extensive management reports. Our team can create savings reports in any file type from any field and customize it to the client’s desires.

Medical Provider Network

• Customizable provider network allows for the best balance of savings and access to care
• Key network providers are identified to produce better outcomes
• Direction of care tools to examiner
• Feedback sent to network providers on outcome
• Integrated contracted ancillary networks
• Positive relationships with key network providers and the medical community
• Customizable MPN website