Skip to main content
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

Pharmacy Utilization Reviews for Medication Optimization

Support Innovative Healthcare Treatment While Optimizing Member Outcomes and Controlling Costs

Pharmacy Reviews You Can Count On

MRIoA provides clinical pharmacy utilization review services and utilization management analytics that support innovative healthcare treatment while optimizing member outcomes and controlling costs.

By partnering with us, Pharmacy Benefit Managers (PBMs) can implement cost-saving solutions while increasing member satisfaction and ensuring members have access to the right medications at the right time.

Pharmacy Benefit Managers

MRIoA focuses on the following services for health plans:


MRIoA can be your fully outsourced solution, or support seasonal overflow work, including after hours, weekends, and holidays.

Reviewers: Pharmacy Techs, Pharmacists, Physicians

Pharmacy Benefit Managers
Pharmacy Benefit Managers


We handle appeal determinations for clinical-based denials.

Reviewers: Specialist Physicians, Non-Specialist Medical Directors and/or Pharmacists


(Reconsiderations and Redeterminations) 

Get the clinical depth you need to ensure full compliance for Medicare.

Reviewers: Non Specialty-Matched and Specialty-Matched Physicians

Pharmacy Benefit Managers
Pharmacy Benefit Managers


MRIoA can assist with full P&T committee support and help ensure Pharmacy Benefit Managers are CMS compliant.

Reviewers: Pharmacists, Medical Directors and Specialty-Matched Physicians


Gain access to our proprietary data warehouse covering 220 million lives and 40 years of medical review outcomes. MRIoA Insights™ provides utilization management analytics and  industry benchmarking to drive clinical and business decisions. Deepen your view of prior authorizations and appeals by comparing industry-level denial and overturn rates and much more.

Learn More
Pharmacy Benefit Managers

MRIoA’s High-Cost Specialty Drug Review Services Include:

  • Commercial
  • Medicaid
  • Medicare Parts B and D
  • ACA Exchange

Optimize High-Cost Specialty Drug Spend

MRIoA’s specialty drug reviews allow PBMs to leverage physician specialists to ensure adherence to evidence-based guidelines for high-cost drugs. This allows you to support the right treatment for medical conditions,  maintain the same efficacy for the patient while reducing cost where a therapeutic interchange is available.

Learn More
Pharmacy Benefit Managers


Download the Fall 2023 Regulatory Round Table DiscussionWebinars

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

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

Provider Gold Card

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

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.

Why Delay?

Harness the power of an independent review to ensure evidence-based care and appropriate utilization of treatments.

All fields are required

First Name
Last Name

How Can We Help You?
Limited to 250 characters