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Initiating a Case Review:

After reading the disclaimer below, click here to view our Service Request Form, which you can print out, fill in and fax back to us at 215.855.5318.

Disclaimer: Due to varying state and health plan requirements, this website may not be used to initiate an independent medical review. To request a review, contact your health plan or your state insurance or health department. Only an authorized representative of a health plan or state government may use the Service Request Form to initiate an independent medical review.

How to Initiate a Case Review

1. To initiate a case review, please fax the completed IMEDECS Service Request Form to our office at 215-855-5318. It is necessary to have complete information to clearly understand your request and to screen for conflicts of interest.
    
2. Upon case acceptance, IMEDECS will send a fax with the case reference number and the contact information of the Case Manager overseeing the review.
   
   
3. A case manager will review the service request form and will contact you if additional information is required.
   
   
4. For expedited reviews, please contact the IMEDECS office immediately via phone at 215-855-IMED (4633). Advance notice is greatly appreciated and essential to completion of the review in the required time frame. This also allows IMEDECS to initiate expert reviewer panel selection and begin the process.
   
   
5. Information needed during the call for an expedited review is as follows:
   • Patient's name, age, sex
   • Diagnosis(es)
   • Treatment, procedure, or drug under review
   • Treating facility name and address
   • Treating physician name, address, phone number and specialty
   • Time frame for return of review
   Please follow up by immediately faxing the completed service request form.
   
   
6. For expedited reviews, we ask that you immediately fax them to 215-855-5318 or upload them to AccessIMEDECS.com .
   
   
7. For standard reviews, IMEDECS asks that the health plan send copies of medical records, uploaded to AccessIMEDECS.com, fax or via overnight delivery to the IMEDECS office. Please send the records as soon as possible after sending the completed service request form.
   
   In order to maintain patient confidentiality, all documents containing patient information should be enclosed in a separate envelope marked private and confidential inside the delivery envelope.