Request for Utilization & Treatment Review

REOH provides expedient Utilization & Treatment Review services for the industries of workers’ compensation, auto, liability, and group health. File reviews use an evidence-based approach and can uncover excessive treatment and expenses pertaining to a claim. Examples of cases that would benefit from a file review are questions pertaining to causation, medication usage/costs, and/or appropriate treatment/overutilization. A REOH physician will objectively review a maximum number of 25 pages of medical records and provide guidance.

REOH’s Utilization & Treatment Reviews are beneficial when one or more of the following exist:

  • Causation Assessment needed

  • Excessive claim costs

  • More than reasonable number of visits to the same provider with no functional improvement

  • Questionable relatedness of treatment to a specific claim

  • Questionable reasonableness of treatment

  • Potential pharmacy overutilization

  • Aggravated or exacerbated pre-existing condition(s)

  • Catastrophic or permanent injuries

  • Frequent specialty consultations/diagnostic testing with no definitive diagnosis

  • Establishing causation in cases of delay in reporting an injury or delay in seeking treatment for a specific claim

  • Lack of medical documentation or evidence-based treatment plan

Turnaround time is a maximum of four business days from medical record submission.

To ensure that reviews are based on the best evidence-based information available, REOH uses legally defensible guidelines (found here).

REOH cannot review files regarding: Medicare supplement, disability income, hospital indemnity, specified accident, credit, long term care, and non-governmental self-funded plans.

Date of birth *
Date of birth
Gender *
Date of injury or claim *
Date of injury or claim
What will this file review be addressing? You may include up to three questions total:
Limited to 3 additional questions
Date you have submitted this file review form *
Date you have submitted this file review form
How will you be submitting the records? *

All questions with an asterisk (*) are required fields.

After submitting this form, please fax records to 833-734-REOH (7364) or email to Leah, at lcm@reoh.com. We’re happy to help if you have questions about what records to send, feel free to contact Leah with questions.

REOH will contact you within 24 hours during the work week (with the exception of office closures) with confirmation your submission and records were received.