Services: NJ Pre-Cert

Pre-certification

Since the enactment of the New Jersey Automobile Cost Reduction Act of 1998, Active Care Auto has provided Decision Point Review (DPR) and Pre-certification services on behalf of the insurance industry. Active Care Auto has an approved plan on file with the New Jersey Department of Banking and Insurance.

Active Care Auto’s professional staff will implement your plan for Pre-certification or Decision Point Review. If your organization requires assistance with approval or developing your plan, our experienced staff is available to assist with your filing.

• Pre-certification / DPR services can be a stand-alone review or incorporated as part of a comprehensive utilization review / case management program
• Eliminates inappropriate or unrelated medical treatment
• Reports from our board certified medical professionals provide rationale for determinations that will “hold up” in legal review
• Compliance with New Jersey Statutes
• Experienced Registered Nurse Case Managers
• Web Based System available for client access using integrated Technology
• Arbitration Support Available by Legal Nurse Consultant

Request a NJ Pre-Cert referral

Medical Director Reviews (MDR)

If a treating provider proposes care that is outside the guidelines of the New Jersey Care Path’s or beyond the scope of nursing, our board certified physicians are utilized to review the claim for medical necessity and appropriateness. Active Care Auto’s Medical Directors are practitioner’s board certified in their specialty. When indicated, our physicians may verbally consult with the treating provider or collaborate on the best course of treatment for the eligible injured party. A report is provided, with rationale, documenting the outcome of the determination.

• Reports supporting determinations that stand up to legal review
• Board Certified Practitioners of all specialties, with like specialty review, as mandated by NJDOBI
• Board Certified reviews completed within the mandated 72 hour time frame
• Physicians available for telephonic or onsite testimony

Request a NJ MDR referral

Life Care Plans

Definition: "A dynamic document based upon published standards of practice, comprehensive assessment, data analysis and research, which provides an organized, concise plan for current and future needs, with associated costs, for individuals who have experienced catastrophic injury or have chronic care needs."

Active Care Auto will provide our customers with a complete life care plan including accident history, present treatment, future treatment, medications and a breakdown of medical costs.

Our life care planners play an important role applying expert knowledge of the psychosocial, medical, and economic aspects of disabilities and chronic health care conditions.

Request a Life Care Plan referral