ABOUT US
Advancing care with timely, evidence-based, compliant clinical reviews drives better decisions, improves outcomes, and reduces costs.
Every care decision matters. That’s why we’ve spent 40+ years building the expertise, insight, and technology healthcare leaders trust to make those decisions with clarity and confidence.
WHO WE ARE
Motivated by Purpose. Powered by Clinical Expertise
Founded in 1983, we’re a clinically-driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to healthcare organizations.
Excellence starts with our people. We bring together the nation’s largest and most specialized network of physician reviewers – licensed in all 50 states and covering more than 150 specialties to deliver evidence-based clinical decisions that you can confidently trust.
Supporting this network is a highly skilled internal team of physicians, nurses, pharmacists, and other clinicians who uphold our rigorous standards of quality, timeliness, and compliance.
Our leadership team blends deep industry expertise with forward-thinking innovation to continually improve the way clinical review and utilization management are delivered.
Every case we review is backed by our nationwide panel and internal team of specialists who share one commitment — reducing complexity, improving outcomes, and driving smarter care across the healthcare ecosystem.
Every case we review is backed by our nationwide panel and internal team of specialists who share one commitment — reducing complexity, improving outcomes, and driving smarter care across the healthcare ecosystem.
900
clients
11
years average client tenure
2.4
million reviews per year
700
Physician Reviewers
150
Specialties
Committed to Quality, Security, and Performance.
NCQA – UM
NCQA is a non-profit organization dedicated to improving healthcare quality. The NCQA seal is a widely recognized symbol of quality. MRIoA is NCQA accredited in Utilization Management (UM).
URAC – HUM
URAC is a non-profit independent accrediting agency that is known as a leader in promoting healthcare quality. Accredited organizations demonstrate a commitment to quality and excellence with consistent compliance with best practices. MRIoA holds URAC accreditation in Health Utilization Management (HUM).
URAC – IRO
URAC’s Independent Review Organization (IRO) accreditation standards validate that third-party organizations providing medical determinations are committed to a fair and impartial peer review process for both patients and physicians. MRIoA holds URAC accreditation in Independent Review Organization (IRO).
HITRUST
HITRUST (Health Information Trust Alliance) has developed the HITRUST CSF, a certifiable framework that provides organizations with structure and clarity relating to healthcare industry information security. HITRUST certification signifies commitment to ongoing IT security.
AICPA SOC
SOC for Service Organizations reports are designed to build trust and confidence in services performed and controls employed through a report by an independent CPA and validation that the systems used to process users’ data maintain the confidentiality and privacy of information.
SIIA
The Self-Insurance Institute of America, Inc. (SIIA) is a member-based association dedicated to protecting and promoting the business interests of companies in the self-insurance and captive insurance industry such as TPAs, Captive Managers, Excess/Stop-Loss Carriers and others.
Let’s Make Every Care Decision a Confident One
Partner with MRIoA to improve outcomes, control costs, and stay ahead of regulatory change.