The MRIoA Clinical Solutions Platform

ClientTools™ include an integrated case submittal process and fully customizable submittal forms, workflows, robust reporting capabilities and access control.

MRIoA uses a nationwide network of board-certified physicians and professionals in all specialties and subspecialties of medicine that are in active practice. Reviewer Tools™ provides a simple interface for our review panel to access patient records, submit reviews, collaborate, learn and engage in a simple phone app or web-based platform.

MRIoA’s API solution significantly improves operational efficiency while reducing the cost of data entry through the direct transfer of case information without human interaction.  Our API can connect directly to your own system or through an UM/CM workflow platform, resulting in realignment of operational resources to higher ROI activities.

MRIoA’s physicians, nurses and pharmacists work directly in  our clients’  case processing systems to review and process cases, seamlessly integrating workflow and enhancing collaboration as we apply clinical guidance to the full patient record and ensure appropriate care.

Proprietary software leverages artificial intelligence to facilitate and enhance the processing of clinical cases for quality and independent clinical reviews.  Automating appropriate elements of case analysis, including data extraction, pattern recognition and decision support, improving the efficiency, consistency and quality of final  reviews. Following the use of this tool set, every case is re-reviewed by a clinician to ensure quality.

Experience streamlined, fully customizable prior authorization from end-to-end prior authorization solution with ClearPath Prior Auth™. Our integrated solution suite combines powerful data-driven tools to address: PA optimization, proactive second opinions, provider gold carding, and management of high-cost specialty drugs in a single workflow.

MRIoA’s PA Optimization(™) combines ~40 years of clinical expertise in Prior Authorization and appeals analytics across ~900 customers and 6,500 procedures to help optimize your PA program, enabling appropriate care for your members.  Our review results efficiently identify areas of savings and improvement while reducing your total number of prior authorizations.

MyCareChoices™ is a proactive telehealth second opinion solution tied to approved prior authorizations that enables members to better understand their condition and treatment options, saving money, ensuring the right patient care, and avoiding unnecessary procedures.

High-Cost Specialty Drug Reviews allow health plans, TPAs and PBMs to leverage national experts  through peer-to-peer calls with prescribers to ensure medication is optimized for the patient.

Gold carding physicians involves granting certain providers the ability to bypass the prior authorization process based on their history of high-quality care and adherence to evidence-based guidelines. With the growth in state legislation mandating Gold Carding, MRIoA’s solution eases the strain on internal staff, reduces cost, ensures the right care and helps you stay compliant.