MRIoA transforms the member experience for health plans by providing trusted clinical guidance, second opinions and appropriate utilization analytics that reduce costs and improve the quality of care for patients.

Our reviews are thoroughly researched, summarized and supported, and our extensive experience in the peer review industry has allowed us to streamline processes, resulting in the fastest turnaround time (TAT) in the industry.

SERVICES FOR HEALTH PLANS

Clinical and Utilization Reviews

  • Initial Reviews
  • Appeals
  • Federal and State External Review
  • Allied Reviews
  • Dental Reviews
  • Quality of Care Reviews
  • Special Investigations Unit (Fraud, Waste and Abuse)
  • Diagnosis-Related Group (DRG) Clinical Validation Review
  • Pharmacy Reviews (Commercial, Medicare Parts B and D)
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Second Opinions

Fast, reliable second opinions for patients with MyCareChoices™ – Your 2nd Opinion

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MRIoA Insights™ UM Benchmarking Analytics

Deepen your view of prior authorizations (PAs) and appeals by comparing industry-level denial and overturn rates.

Learn More
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| Your Trusted Partner for Clinical Guidance

“MRIoA has always been my first choice for peer reviews, UCR assistance, and plan language interpretation regarding clinical. The reviews are easily understood, and the clinicians always answer all questions that are posed for review.”

- Supervisor at a Nationwide TPA

“I have always had a great experience with MRIoA. The staff members are the experts in their positions. Absolutely one of the best companies for communication and problem solving and correcting/clarifying outcomes. Always receive updates and the staff is wonderful to work with.”

- Case Manager at a Medical Management Organization

“Management is responsible for employee attitudes. Your employees have been nothing but professional, friendly, and always aim to respond to my questions in a timely manner. I appreciate that every bit as much as I appreciate the quality of the reviews. Kudos to management and kudos to staff.”

- Claims Specialist at an Insurance Provider

“Your staff is extremely easy to work with, gracious, follows up appropriately, and responds quickly. It's wonderful to work with your company in an age where customer service is dead/dying! I have always been a strong advocate of excellent CS, so it's great to see elsewhere! I'm very happy with the review process and format in which the review is provided.”

- Claims Manager at an Insurance Benefit Administration Company

“Positive attitude, turnaround time and completeness of reviews. I truly appreciate our relationship with your company. I have been very impressed with overall responsiveness and the ability to develop unique solutions for customers without a great deal of hassle for the customer.”

- Director of Medical Management at a Non-profit Health System

600

PHYSICIAN AND ALLIED HEALTH REVIEWERS

150

SPECIALTIES

30

MDs/DOs ON STAFF

20

INTERNAL SPECIALISTS

25

NURSES ON STAFF

20

PHARMACISTS ON STAFF

Physician

Licensure

IN ALL
50 STATES