Daily operations for any healthcare organization can be very fluid. An influx of new business or an unforeseen project may place stress on clinical resources. At MRIoA we often hear about the need for additional medical directors and clinical support when these circumstances take place. Usually the dynamics of the situation do not allow for recruitment and additional clinical staffing. Budgets and other considerations can also make it challenging to simply hire more resources. To help meet that need MRIoA has been developing a new product to support claims operations at the medical director level. The service can be used on an as needed basis or as part of an ongoing claims operations support process. Here are a few of the advantages our medical director review provides.
1. MRIoA brings over 30 years of experience and URAC and NCQA compliance to the equation
2. MRIoA is familiar with the application of criteria sets and plan language for case review.
3. MRIoA’s web portal allows for easy submission of cases. Additionally we have experience working in our client’s systems to receive and complete cases.
4. Our medical director service provides sameday/24 hour turnaround for all initial case reviews.
5. MRIoA is an SSAE16 certified company.
6. Our medical director services can relive you of added costs of staffing and administration. Initial review services are provided at a fixed case rate.
We are interested in your feedback to these services and would welcome any questions about these services or opportunities to help support your claims operations.
Jeff Rollins, National Marketing