Utilization Review, Data-Driven Optimization Solutions and Proactive Second Opinions
The Gold Standard for Medical Review Services
Founded in 1983, Medical Review Institute of America, LLC (MRIoA) is the top medical review company in the United States. With the largest, most extensive review network, industry-leading turnaround times (TATs), and UR licensing in all states that require it, our professionalism, enthusiasm and collaborative approach are transforming clinical care delivery nationwide.
MRIoA provides independent clinical and utilization reviews, proactive second opinions and appropriate utilization analytics for many of the country’s largest health plans, PBMs, TPAs, government entities and self-insured employers.
The MRIoA Way
At the heart of everything we do at the Medical Review Institute of America is a set of tenets called The MRIoA Way.
40+ years of review experience with over 900+ customers and more than 1,000 clinical review specialists at your disposal 7 days a week.
Honesty, integrity and confidentiality from every employee who handles a case throughout the entire review process.
Continual innovation to develop new data-driven solutions and provide value to the patients we all serve.
Meet Our Leadership Team
Testimonials
MRIoA’s Accreditations, Certifications and Memberships include:
URAC – HUM
URAC is a non-profit independent accrediting agency that is known as a leader in promoting healthcare quality. Accredited organizations demonstrate a commitment to quality and excellence with consistent compliance with best practices. MRIoA holds URAC accreditation in Health Utilization Management (HUM).
URAC – IRO
URAC’s Independent Review Organization (IRO) accreditation standards validate that third-party organizations providing medical determinations are committed to a fair and impartial peer review process for both patients and physicians. MRIoA holds URAC accreditation in Independent Review Organization (IRO).
NAIRO
NAIRO (National Association of Independent Review Organizations) is a national trade association of URAC-accredited IROs whose primary mission is to protect the integrity of the independent review process.
HITRUST
HITRUST (Health Information Trust Alliance) has developed the HITRUST CSF, a certifiable framework that provides organizations with structure and clarity relating to healthcare industry information security. HITRUST certification signifies commitment to ongoing IT security.
NCQA – UM
NCQA is a non-profit organization dedicated to improving healthcare quality. The NCQA seal is a widely recognized symbol of quality. MRIoA is NCQA accredited in Utilization Management (UM).
SIIA
The Self-Insurance Institute of America, Inc. (SIIA) is a member-based association dedicated to protecting and promoting the business interests of companies in the self-insurance and captive insurance industry such as TPAs, Captive Managers, Excess/Stop-Loss Carriers and others.
AICPA SOC
SOC for Service Organizations reports are designed to build trust and confidence services performed and controls employed through a report by an independent CPA and validation that the systems used to process users’ data maintain the confidentiality and privacy of information
Best Places to Work
MRIoA earned the 2024 Top Workplaces USA award, issued by Energage. Top Workplaces USA offers national recognition for large organizations with more than 150 employees operating in multiple markets. This award is in addition to our Top Workplaces Salt Lake City award received every year since 2018.
CAHP
CAHP works to sustain a strong environment in which our member plans can provide access to products that offer choice and flexibility to the Californians they serve. Most of our member plans provide coverage to Californians through the individual and group markets.
TAHP
Texas Association of Health Plans (TAHP) is the statewide trade association representing health insurers, Medicaid plans, Medicare Advantage plans, and other related healthcare entities operating in Texas.
Top Workplace for Remote Work
MRIoA is a recipient of the 2024 Top Workplaces for Remote Work award, featured by Monster, a global leader in connecting people and jobs, and awarded by Energage, a purpose-driven organization that builds and brands employers of choice, determines the awards through an employee survey.
Itiliti Health
Itiliti Health’s best-in-class technology leverages AI and automation to accelerate communication between payers and providers, creating a touchless prior authorization solution that applies the right medical policies while helping to automate prior authorizations quickly, securely and cost-effectively.
The Leading Voices in Healthcare
Heather Grigo, MD
Medical Director
Byron Harris, PharmD
Vice President of Pharmacy Programs
Tuan Do, PharmD, MBA, BCPS
Clinical Review Pharmacist
Sybel Beattie, RN, CLNC
Sr. Director of Nursing Services
Jacob Woods, MSN, RN
Clinical Quality
Ginger White, RN
Manager – Nursing Operations
Why Delay?
Harness the power of an independent review to ensure evidence-based care and appropriate utilization of treatments.
