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Independent clinical review is often an overlooked solution in health plan management. Despite – or perhaps because of – an overwhelming number of challenges, including lack of MD specialist resources, lack of data analytics and inefficient turnaround times, health plans, pharmacy benefit managers (PBMs), third-party administrators (TPAs), government, and self-insureds don’t always understand the potential impact on business and patient/member satisfaction that outsourcing utilization management (UM) and clinical review to a trusted partner can make.
Download MRIoA's latest white paper to learn more about transition from a traditional UM to offer more innovative and technology-enabled solutions.