Medical Review Institute of America, LLC (MRIoA) was founded in 1983 and has grown to become the top medical review company in the United States. It specializes in independent clinical and utilization reviews, proactive second opinions, and utilization analytics for many of the country’s largest health plans, PBMs, TPAs, government entities, and self-insured employers. MRIoA operates with the largest, most extensive review network and industry-leading turnaround times, maintaining utilization review licensing in all states that require it.
MRIoA employs a nationwide network of board-certified physicians and professionals in all specialties and subspecialties of medicine who are in active practice. These experts review prior authorizations and appeals for treatment to determine if they meet nationally accepted medical guidelines and healthcare plan requirements. The review work is performed in compliance with ERISA/DOL and state laws, serving as an unbiased and external source of expertise.
The company is committed to transforming clinical care delivery through professionalism, enthusiasm, and a collaborative approach known as The MRIoA Way. The organization supports its reviewers by providing opportunities to stay informed in their specialty areas, understand prior authorization approvals better, and supplement their incomes by completing cases remotely across the United States.
MRIoA’s extensive team includes over 500 physicians, 21 pharmacists, and 19 nurses, covering more than 150 specialties, thereby enabling comprehensive and specialized clinical reviews. The company’s technology-enabled utilization management solutions impact the healthcare of over 35 million lives, demonstrating its market leadership in healthcare cost management.
Overall, MRIoA’s mission is to provide high-quality, data-driven medical review services that enhance clinical care and appropriate utilization of healthcare resources nationwide.