Technology-Enabled Solutions From Trusted Medical Experts
Increase Employee Satisfaction While Decreasing Your Costs
MRIoA empowers self-insured employers by providing trusted clinical guidance and second opinion solutions that help you decrease costs and increase member satisfaction by providing conservative treatment options.
MRIoA’s real-time utilization management benchmarking analytics from MRIoA Insights™ also help you deepen your view of prior authorizations (PAs) and appeals, and get actionable intelligence to improve your PA process.
MRIoA focuses on the following services for self-insured employers:
PROACTIVE SECOND OPINIONS
MyCareChoices™ delivers a telehealth 2nd opinion from a MD specialist as part of the approved Prior Authorization process. This enables the member to better understand their condition and treatment options, so they can make the best decision for themselves and their family. MyCareChoices™ delivers ~$800K per 100K members in savings by reducing unneeded procedures and requires no IT integration.
- Initial Reviews
- 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)
- Specialized Reviews (Disability, Prudent Layperson, Workers Comp, etc)
CLINICAL AND UTILIZATION REVIEW
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.
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.
Harness the power of an independent review to ensure evidence-based care and appropriate utilization of treatments.