Cleveland Clinic Clinical Review Training Guide
Welcome to the Cleveland Clinic Clinical Review Training Guide
Our guide is here to help you learn about the Cleveland Clinic Clinical Review. Inside, you'll find answers to common program questions - from an overview of the Clinical Review process, including how to submit a referral, to introductions to our dedicated Virtual Liaison, and what to expect during post-review support.
Our goal to ensure you have a full understanding of the Clinical Review process, so you're comfortable assisting plan members throughout the process.
If you have any questions, please contact the Cleveland Clinic Clinical Review team at [email protected].
Before we get started, let's go over the basics:
What exactly is a Clinical Review?
A Clinical Review is a remote medical record review and screening by an expert Cleveland Clinic physician specialist. It is intended to deliver essential treatment information and education to participants and screen for potential treatment options. It empowers participants to make informed decisions about their healthcare. This service is not offered to acutely ill individuals who require immediate medical attention.
The goal? To provide your plan members with peace of mind knowing they have an accurate diagnosis and optimal treatment plan.
Eligible participants must be:
- an employee or covered dependent on the employee health plan
- have a medical diagnosis and treatment plan from an existing physician
A Clinical Review can be completed for any diagnosed condition. Some of our most common specialty areas are:
- Neurology
- Orthopaedics
- Digestive Disease
- Heart, Vascular & Thoracic
- Oncology
What are the benefits of participating in a Clinical Review?
Click the arrow on each box below to learn more about the benefits of Cleveland Clinic's Clinical Review.
The Clinical Review empowers the participant with education and connects them with leading specialists, offering a personalized and streamlined healthcare journey.
The Clinical Review offers a personalized connection and assistance with record collection and scheduling.
Cleveland Clinic's leading experts review every case, ensuring the right individual receives the right care at the right time.
Cleveland Clinic's Clinical Review helps ensure your plan members have the most accurate diagnosis and treatment plan, leading to better overall health outcomes.
Misdiagnosis and mistreatment leads to needless risks and costs for the employer and plan member. Cleveland Clinic's Clinical Review helps plan members avoid unnecessary medical procedures thus reducing overall healthcare expenses.
Why Cleveland Clinic?
Meet Our Virtual Liaison Team
Our experienced team is committed to guiding your plan members through every step of the journey. Participants will be paired with a dedicated Virtual Liaison who will support them throughout the Clinical Review process by:
- Assisting with medical record collection
- Answering any questions they have about the Clinical Review program
- Collaborating with a Cleveland Clinic physician specialist to review their records
- Contacting them after the Clinical Review to share information and education about their diagnosis.
Tim Gaydos-Baker
Tim Gaydos-Baker has been a Cleveland Clinic caregiver for 11 years, starting in the customer service department as a phone rep and then a quality assurance specialist. He now works as a project manager in the Product Operations department, assisting in facilitating programs that help more patients receive the world class care Cleveland Clinic provides, including the Clinical Review program.
Supporting Clinical Review patients is important to Tim because health issues are something everyone will need to deal with at some point, and he knows how reassuring it can be to have some of the best specialists in the world weigh in on your care and ensure you are on the best path possible. Being able to reduce the stress and anxiety patients may feel about their situation is what he strives to do every day.
Jackie Stafford
Jackie Stafford has worked as a Cleveland Clinic caregiver for six years. Her journey in patient care began as a Patient Service Specialist and then a Surgery Coordinator for Pain Management. She currently works as a Client Care Coordinator with the Product Operations Department assisting with the Clinical Review program.
Jackie's passion for helping Clinical Review patients comes from her own experiences with limited healthcare services. Dealing with health issues can cause a lot of uncertainty and stress. Jackie is passionate about helping patients talk through their concerns, and providing reassurance that they will receive world class care from the best specialists.
Mohamed Ibrahim
Mohamed brings a diverse background in healthcare and program management. With a strong educational foundation in physical therapy from Youngstown State University, he has gained extensive experience in both clinical and administrative roles at Cleveland Clinic. This hands-on experience in healthcare settings has fostered a deep understanding of patient care, operations, and management.
In addition to clinical work, Mohamed has also managed programs at a drug rehabilitation recovery center, where they focused on improving patient outcomes and operational efficiency. Currently, he serves as a Project Manager II for Product Operations, bringing fresh, innovative ideas to enhance patient experience and optimize operations. With a passion for making a meaningful impact, he is committed to driving positive change in healthcare through thoughtful project management and creative solutions.
Let's get started...
Clinical Review Process
The following sections will guide you through the Clinical Review process in four simple steps, beginning with the participant referral.
Step 1 | Participant Referral
Plan members can find program information and start the referral process on the LCSC website (thelcsc.com/clinicalreview).
The website explains how the program works, including:
- What it is and who is eligible
- The process
- Coordination with existing providers
There are two options for plan members who want to get started - they can enroll online or by phone.
If a participant chooses to enroll online, they will complete the secure form (https://www.thelcsc.com/cccr25-1).
To enroll by phone, participants can call 833-355-0454.
Their information will be shared with the Cleveland Clinic Clinical Review team and they will be assigned a dedicated Virtual Liaison, who will assist throughout the process.
Step 2 | Medical Record Collection
Once the participant begins the Clinical Review process, they will be connected to their dedicated Virtual Liaison who will guide them through the medical record collection process.
The Virtual Liaison will provide a tailored list of the medical records we need based on their diagnosis. To make this process as easy and efficient as possible for the member and their local doctors, we collaborate with a medical record collection company.
It's essential for the participant to provide the names of their hometown doctors and the locations of their appointments and tests - this ensures we gather all the necessary medical records as quickly and efficiently as possible.
The collection process typically takes about 10 business days.
Step 3 | The Clinical Review
Next, with the support of the Virtual Liaison, the Cleveland Clinic physician specialist will conduct the Clinical Review.
The Virtual Liaison will collaborate with a Cleveland Clinic physician specialist to review the participant's medical records. The physician will determine whether their diagnosis and treatment plan align with the standard of care for patients with similar symptoms and conditions.
Step 4 | The Clinical Review Results
The Virtual Liaison will contact the participant to share the findings of the Clinical Review.
After the Cleveland Clinic physician reviews the clinical information, the Virtual Liaison will schedule a call to walk the participant through the findings of the Clinical Review, typically within two business days.
What to Expect:
During the meeting, the Virtual Liaison will share whether the Cleveland Clinic physician agrees with the participant's current diagnosis and treatment plan or if there are alternative options to consider. We find that treatment plan modifications are recommended in up to 60% of completed Clinical Reviews.
This call is provided at no cost to the participant and will not be billed to their insurance.
Support After the Clinical Review
If the Cleveland Clinic physician confirms the participant's current diagnosis and treatment plan, they can confidently continue care with their local providers.
If Cleveland Clinic recommends further evaluation or a change to the participant's treatment plan, their dedicated Virtual Liaison will personally guide them through the next steps.
They'll ensure a seamless transition to the scheduling team, who will help coordinate appointments with Cleveland Clinic physician specialists using their commercial insurance.
Travel to a Cleveland Clinic facility may now be necessary. On-site appointments are required for some specialty areas. Their Virtual Liaison will provide more information, including discounted hotel pricing.
We strive to make their travel as convenient as possible. For more information, please review our campus visitor guides:
Cleveland Clinic Main Campus (Cleveland, Ohio): Parking, Lodging and Transportation
Cleveland Clinic Florida: Parking, Lodging and Transportation
Participant Satisfaction
"I was told my condition merited additional testing and I was offered the chance to meet with a Cleveland Clinic specialist.
I was so relieved to finally have the right diagnosis that explained the symptoms I've been experiencing for more than a year."
Allen C. | Clinical Review Participant
Frequently Asked Questions
Click the arrow on each box below for responses to our frequently asked questions about the Cleveland Clinic's Clinical Review.
Your employer and Cleveland Clinic have teamed up to give you and your family access to Cleveland Clinic's world renowned specialists. They will review your diagnosis and medical records to ensure you are on the right track.
Your health and well-being are top priorities. This program is designed to provide peace of mind, knowing you’re in the hands of trusted professionals who are committed to delivering the best possible outcomes. Cleveland Clinic, recognized across the U.S. and around the globe for its exceptional care, is here to support you on your health journey.
Lead a vibrant, healthy life with confidence, knowing you have access to world-class care.
A Clinical Review is completed by a Cleveland Clinic specialist who will conduct a thorough review of the participant's diagnosis, medical records, and/or treatment plan. The specialist will determine if the plan of care is consistent with what they would recommend for a patient with their diagnosis or if they suggest an alternative course of action.
A dedicated Virtual Liaison will schedule a virtual meeting with the participant to review the outcome of the Clinical Review.
Based on the outcome of the Clinical Review, the participant can determine if they would like to continue with their current treatment in their local market or schedule an appointment with a Cleveland Clinic provider for further evaluation.
The Clinical Review is conducted electronically, so no travel is required. If the participant chooses to seek care at Cleveland Clinic as a result of the outcome of the Clinical Review, travel may be required.
The ideal participant has been diagnosed with a serious, complex or rare condition and is interested in learning about optimal and best-in-class treatment plans.
• A dedicated Cleveland Clinic Virtual Liaison will assist in collecting the participant's medical records to support their existing diagnosed condition.
• Next, Cleveland Clinic will match their condition with the correct physician specialist who will review the medical records provided. They will determine if the plan of care is consistent with what they would recommend for a patient with their diagnosis, or if they'd suggest a modification to the existing plan.
*Please note: The participant will not interact directly with a physician during the Clinical Review process.
• Based on the Clinical Review screening, the participant will have the opportunity to continue with their current treatment plan confidently in their home market. Or, should the screening indicate an opportunity to optimize the treatment plan, a Virtual Liaison will assist in scheduling an appointment with a Cleveland Clinic physician specialist for further evaluation and treatment options.
A dedicated Virtual Liaison will work with the participant to obtain their medical records. Typically, after their medical records have been collected, they'll receive feedback within five business days, through a call with their Virtual Liaison.
The Clinical Review is offered at no cost to as part of the employer sponsored health plan.
If the participant decides to seek care at Cleveland Clinic after their Clinical Review, their Virtual Liaison will help facilitate a connection to the right physician specialist and assist with appointment scheduling. Depending on where they reside, they may be eligible for a virtual visit. All costs will be billed through their insurance plan. Please instruct them to contact the number on the back of their health plan ID card to understand what services are covered.
Travel to a Cleveland Clinic facility may now be necessary. On-site appointments are required for some specialty areas. Their Virtual Liaison will provide more information, including discounted hotel pricing.
We strive to make their travel as convenient as possible. For more information, they can review our campus visitor guides:
Cleveland Clinic Main Campus (Cleveland, Ohio): Parking, Lodging and Transportation
Cleveland Clinic Florida: Parking, Lodging and Transportation
Patient-centered care: We don't just care for a patient's health conditions. We care about the patient. With more than 3,900 employed physicians to diagnose and treat patients, our staff is committed to providing the best care for serious and complex medical conditions.
National recognition: Cleveland Clinic is recognized in the U.S. and throughout the world for its expertise and care.
Collaborative providers: Our providers are board-certified and fellowship trained experts who work together to create a personalized treatment plan. Only the highest standards ensure excellent outcomes.
Innovation and research: We're focused on today - and tomorrow. Our focus on research and offering the latest options means that we offer a wide range of clinical trials and other care that can't be found elsewhere.
Program Materials and Helpful Links
Clinical Review Quick Reference Guide
This handy guide gives a quick overview of the Clinical Review program. You can print it out and use it as a tool to explain the program to plan members.
Clinical Review Guide for Participants
We created this guide to help participants understand the Clinical Review process. Our Virtual Liaisons will share this guide once they have been connected to a potential participant.
