Medical Review Services
For 30 plus years, MRIoA has perfected the medical review process to meet your external review needs.
MRIoA provides nationwide medical review services for many of the country's largest insurance carriers, TPA's, PBM's, workers compensation carriers, healthcare systems, disability carriers, and state and federal review agencies. MRIoA holds dual URAC accreditations in Health Utilization Management and Independent Review Organization as well as certifications by NCQA and SSAE 16. We have extensive experience in the peer review business, and we've learned that in order to provide the premier service in the industry we must stay ahead of the curve. To do this we constantly assess and re-assess our procedures to provide maximum quality, efficiency and value to our clients. Below are a few of the results:
Faster Response Times
MRIoA offers the fastest response times in the industry. Our standard review time currently averages two business days. Our experience has allowed us to streamline every step of the review process, and through our convenient web portal and email notifications clients can track their cases from start to finish. Often our new clients are surprised at how quickly we complete their cases; and they are even more surprised to find that our quality remains at the highest possible level even on cases completed in very short time frames. This is possible because whether a case is completed the same day or within a few days it will go through our extensive quality audit process.
Online Review Services
We understand for many of our clients their primary interaction with MRIoA is over the internet. Realizing this, MRIoA's IT department has created an industry leading web portal which is HIPAA/HITECH compliant. Online users consistently rate satisfaction with the MRIoA web portal at over 95%. The site is designed to allow for intuitive navigation, streamlined case entry and quick answer retrieval. The site also provides clients the opportunity to customize their online experience. This includes tracking, monitoring and reporting of all data entered and communication with the site. Support is provided by our Account Management team with real-time assistance when needed.
In 2010, MRIoA established an implementation team to transition new clients from sales discussions to submitting cases. Early in the process the implementation team will identify opportunities to interface with client systems and will establish lines of communication with the Account Management and Operations departments. Training will be provided to access MRIoA's client web portal to facilitate case referrals. The implementation team will track all cases received during the process to make sure quality and content expectations are being met. Weekly meetings are scheduled to provide ongoing oversight and discussion of client's progress through the process.
Listed below are just a few of the reasons MRIoA is at the top of the peer review industry:
- MRIoA offers one of the largest, most extensive review networks in the external review industry.
- MRIoA's reviewers are sub-specialty matched and have procedural experience with the topic(s) in question.
- MRIoA's offers a secure, industry leading client web portal, "Client Tools."
- MRIoA includes criteria and/or published references with every review.
- MRIoA is licensed for IRO/UR review in all states where required.
- MRIoA's on-site medical directors/clinical nurse auditors do post-review quality checks on every case.
- MRIoA holds dual URAC accreditations and certifications by NCQA and SSAE 16. (Currently working on HITRUST security certification.)
- MRIoA is committed to providing prompt, professional, friendly and proactive customer service.
- MRIoA is dedicated to forging long lasting, mutually beneficial relationships with each of our clients.
MRIoA Mission Statement
MRIoA's mission is to provide balanced, decisive and well-supported expert review services to ensure clinically appropriate healthcare coverage determinations. We show our dedication to client satisfaction through attention to personal customer service, thorough quality assurance, surprising response times, and constant innovation.
Want additional information? We're happy to provide sample review reports, sample quality reports, and answers to any questions you may have.
"I have been in the claims business for 43 years and have used MRIoA for the past 20 years with 4 or 5 different companies. I've always had good results that were objective and defensible. Thank you for your support and service."