Physical therapy is a significant cost driver especially in workers’ compensation systems. With the aging of Americans with chronic disabilities, physical therapy services are guaranteed to escalate. This will require experienced experts in peer & utilization review that spans the continuum from precertification/pre-authorizations to concurrent and retrospective case review. At present 90% of persons over 65 yrs have at least one chronic condition typically treated through physical therapy. Eighty percent of this group has two or more chronic conditions. The days of bill repricing and cost concessions from providers is waning in favor of a strong trend towards value-based interventions. When it comes to value (or lack thereof), D+WC is the choice when it comes to experience and disability wisdom.

D+WC’s founder, David W. Clifton, PT literally wrote the book on physical therapy peer review. In 1982 he founded Physical Therapy Review Services Inc. or PTRS, the nation’s first utilization review company that exclusively focused on physical therapy record review and medical necessity determinations. There was virtually nothing in the clinical literature pertaining to PT review except for scant Medicare guidelines.

David was invited by the American Physical Therapy Association (APTA) to author an on-going ten year Physical Therapy Peer & Utilization Review column in PTMagazine. David also co-authored the original APTA “Guidelines to PT Peer Review” and served as both a faculty member and consultant in quality & risk management, clinical documentation, evidenced-based practice, reimbursement. David is considered by many including his peers to be one of the pioneers and one of the nation's foremost authorities on PT Peer Review. To view a listing of articles published by David, visit the Resources section.