Why MedReview

Setting the standard for payment integrity.

Why MedReview

Setting the standard for payment integrity.

About MedReview

MedReview has been a leading authority in payment integrity for more than 40 years. As a physician-led organization with a passion for ensuring healthcare claims represent care provided, MedReview provides timely, accurate independent audits and clinical validation of provider claims, saving our clients billions of dollars.

Our Mission

To bring accuracy, accountability and clinical excellence to healthcare.

Our Vision

Be the authority in affordability, quality, and appropriateness of medical care.

Our Values

  • Foster Teamwork and CollaborationCreate an environment where teamwork can promote innovation, increase job satisfaction, resolve problems and develop team member skills
  • Act with IntegrityAct in an ethical, moral, and honest way, even when no one is watching
  • Be AccountableShow up, accomplish the things you said you'd do, take personal responsibility for your work, and trust your teammates
  • Deliver Outstanding ResultsPerform at your highest level, follow through on your tasks and commitments, and hold your team accountable.
  • Pursue Diversity and InclusionCreate an environment where everyone feels equally involved, valued, respected and supported in all areas of the workplace
  • Have FunEnjoy time with colleagues in a relaxed environment to encourage honest and open discussion and trust in one another

Executive Team

Board of Directors

Gail Donovan
Chairman of the Board

Michael R. McGarvey, M.D.
Vice Chairman of the Board

Richard J. Bonforte, M.D.

Governor David A. Paterson, J.D.
Board Member

Marvin Lieberman, Ph.D.
Board Member

Janet Mackin, R.N., Ed.D.
Board Member, Consumer Representative

Daniel Stephens, M.D.
Board Member

Tara A. Cortes, Ph.D., R.N., F.A.A.N.
Board Member

Michael Balistreri
Board Member

Merlin Chowkwanyun
Board Member

Headquartered in New York City, MedReview serves a diverse mix of clients throughout the United States.

MedReview’s portfolio of services is highly scalable and can be configured to meet the specific needs and requirements of our clients. Our approach to payment integrity is unique within the industry because we take great care to ensure that all denials are reviewed by a board-certified physician in the appropriate specialty or sub-specialty.

MedReview’s clinical expertise is highly respected by providers and payors. As a result, payors can count on us to deliver more defensible denials with little to no provider abrasion.

About MedReview

With a reassignment rate of 40% or greater and an appeal overturn rate of less than 5%, we have delivered billions in savings to our clients.

MedReview is a wholly owned subsidiary of the New York County Health Services Review Organization (NYCHSRO), which was founded in 1974 under the Federal Law mandating Professional Standards Review Organizations (PSROs) for Medicare and Medicaid review. The company was formed in 1984 in reaction to a newly deployed CMS project to categorize inpatient hospital labor into Diagnosis Related Groups and to offer utilization management and analysis services to the private sector including health plans, labor unions, TPAs and managed care organizations.

In order to sustain our average annual growth of 40.5% for the last decade, we have invested tens of millions of dollars in automation to maintain our focus on quality. Our steadfast commitment to quality is further evidenced by the accreditation we have received from the Utilization Review Accreditation Commission (URAC).

MedReview is accredited by URAC® as an Independent Review Organization (IRO) and Health Utilization Management (HUM) organization. We are also certified by the HITRUST CSF® Assurance Program, which makes sure our most sensitive data is well protected.

URAC Accredited
URAC Accredited