Independent Review
Objective, independent medical reviews you can trust.
The Patient Protection and Affordable Care Act (PPACA) of 2010 stipulated that all self-insured group health plans and health insurance issuers contract with three Independent Review Organizations (IRO) to review appeals for members who have exhausted all internal appeal levels available to them.
As an IRO with a track record for integrity, consistency and accuracy, MedReview brings added strength to the independent review process, ensuring health plans, third party administrators, and self-insured companies requiring specialty-matched reviews have a trusted partner when the need for independent review arises.
MedReview adheres to URAC’s rigorous standards and promotes an independent review process that is objective, fair and transparent.
Our credentialed panel of board-certified clinical peer reviewers makes it a priority to stay up to date on the most current medical practices and technologies, all relevant federal and state regulations and HITRUST-compliant organizational processes, data security protocols and internal operations to secure the confidentiality of protected patient health information.
Specialty-matched reviews we offer include:
- Medical necessity of services and/or of place of service.
- Experimental/investigational status of proposed interventions.
- Quality of care reviews.
- Procedural and service coding with provision of prevailing charges.
- Administrative/legal/benefit/rescission reviews.