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Get the latest market insights and industry trends on Regulatory, Data, Pharmacy and Health   Download the latest Regulatory Round Table Discussion Impacting 13 states   Listen to the latest podcast on GLP-1 Drugs

Improving Quality of Care

Clinical and Utilization Review Solutions Lower Costs and Provide More Effective Treatment for Patients

Delivering Better Outcomes for Patients, Providers and Payers

MRIoA provides independent clinical and utilization reviews to help health plans, PBMs, TPAs and government entities increase member satisfaction, reduce healthcare costs, and ensure appropriate care.

Our holistic clinical and utilization reviews include: initial reviews, appeals, Federal and State external reviews, allied reviews, dental reviews, quality of care reviews, special investigations, DRG clinical validation and pharmacy reviews.

Conducted by physician, pharmacist and nurse experts, our clinical reviews are delivered with world class speed, access, quality and simplicity. With the largest, most extensive review network in the industry, multiple accreditations, UR licensing in all states, and industry-leading turnaround times (TATs), partnering with MRIoA ensures appropriate care and positive patient outcomes.

Clinical and Utilization Review
Clinical and Utilization Review

Our Clinical Review Services Include:

Clinical and Utilization Review
Clinical Peer Review
Clinical and Utilization Review
Quality of Care
Clinical and Utilization Review
Special Investigations (F/W/A)
Clinical and Utilization Review
Disability
Clinical and Utilization Review
Clinical Incident Management
Clinical and Utilization Review
Workers’ Compensation
Clinical and Utilization Review
Clinical Validations
Clinical and Utilization Review
Medical Policy Review
Clinical and Utilization Review
Coding and Fee Analysis
Clinical and Utilization Review
P&T Committee Support

Our Utilization Review Services Include:

Clinical and Utilization Review
Health and Pharmacy Review
Clinical and Utilization Review
Initial UM (Nurse, Pharmacist, Physician)
Clinical and Utilization Review
Appeals and Grievances (Same or Similar Specialty)
Clinical and Utilization Review
Peer-to-Peer
Clinical and Utilization Review
All Lines of Business (Commercial, Medicaid, Medicare, Exchange, FEP)
Clinical and Utilization Review
Standard and Expedited Review


Clinical and Utilization Review
Clinical and Utilization Review

Specialty Solutions

Clinical and Utilization Review
Behavioral Health
Clinical and Utilization Review
MSK (Musculoskeletal)
Clinical and Utilization Review
Genetics
Clinical and Utilization Review
Sleep
Clinical and Utilization Review
Medical Imaging
Clinical and Utilization Review
Pain Management

Resources

Download the Fall 2023 Regulatory Round Table DiscussionWebinars
09/06/2023

Download the Fall 2023 Regulatory Round Table Discussion

Please download the MRIoA Regulatory Round Table Discussion recording to learn about 13 different state regulations.
Trimming the Weight: Helping Healthcare Companies with the GLP-1 Drug Revolution PodcastPodcasts
07/03/2023

Trimming the Weight: Helping Healthcare Companies with the GLP-1 Drug Revolution Podcast

Listen to our newest podcast and learn more about the GLP-1 drug revolution.
Provider Gold CardAt A Glance
06/22/2023

Provider Gold Card

Learn how MRIoA can ease the burden of the new and existing Gold Card regulations.
Regulatory & Compliance Roundtable Discussion 2023Webinars
05/10/2023

Regulatory & Compliance Roundtable Discussion 2023

Download our latest bi-annual Regulatory Roundtable discussion where we discussed the pending and proposed legislation and other regulations across multiple states.

Drive Cost Savings and Elevate Patient Care

Experience valuable data insights, cost savings, and faster decision-making with our innovative technology and patient-centered approach.
A ClearPath to Clinically Relevant Simplicity.

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