A Transparent and Trusted Review Process
Delivering objective and evidence-based medical determinations.
How Our Review Process Works
Case Submission
Health plans or members submit the denied case for review.
Case Assignment
We match the case with a board-certified physician who has relevant expertise.
Medical Review
The reviewer evaluates all medical records and supporting documentation.
Decision Issued
A clear, evidence-based determination is made either upholding or overturning the denial.
Why Our Process Works
100% HIPAA-Compliant
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Adherence to state and federal guidelines
Physician Network consisting of multiple specialties to ensure compliance and expertise with each given case
Transparent communication between reviewer, physician, health plan and member
Review Integrity
Each review is performed by a licensed, board-certified physician in the appropriate specialty. All reviewers are thoroughly vetted to maintain objectivity, accuracy, and compliance at every stage.