Full URAC Accreditation
Independent Review Organization (IRO)
EXTERNAL REVIEW PROCESS
NMR has full accreditation from URAC as an Independent Review Organization – Comprehensive Review (both Internal & External). NMR is able to provide Independent External Review services under the Federal Affordable Care Act.
Our clients include Insurance Companies, Third Party Administrators, Large Self-Funded Employers, as well as Taft Hartley Plans.
Technical Release No. 2010-02 | U.S. Department of Labor (dol.gov)
STATE BY STATE
NMR maintains Accreditations / Certifications in the states listed below.
Even if you don’t see your state listed, please call us at 1-800-283-8196 to see how we can partner.
|State||Department||Certification / Contract||Certified Since|
|Arizona||Department of Insurance||Independent Review Organization||2017|
|Arkansas||Insurance Department||Independent Review Organization||2010|
|Colorado||Department of Regulatory Agencies||Independent External Review Entity||2000|
|Connecticut||Insurance Department||External Appeal Entity||2009|
|Delaware||Department of Insurance||Independent Utilization Review Organization||2018|
|Georgia||Department of Community Health||Independent Review Organization||2017|
|Idaho||Department of Insurance||Independent Review Organization||2010|
|Illinois||Department of Insurance||Independent Review Organization||2010|
|Indiana||Department of Insurance||Independent Review Organization||2000|
|Kentucky||Department of Insurance||Independent Review Entity||2007|
|Louisiana||Department of Health||Independent Review Organization||2019|
|Louisiana||Department of Insurance||Independent Review Organization||2020|
|Maine||Department of Professional and Financial Regulation||Independent Review Organization||2014|
|Maryland||Maryland Insurance Administration||Private Review Agent||2020|
|Montana||Commissioner of Securities and Insurance||Independent Review Organization||2016|
|Nebraska||Department of Insurance||Independent Review Organization||2014|
|Nevada||Division of Insurance||External Review Organization||2011|
|New Hampshire||Insurance Department||Independent Review Organization||2019|
|New Hampshire||Insurance Department||Independent Review Organization Long Term Care||2019|
|New Mexico||Superintendent of Insurance||Independent Review Organization||2019|
|New York||Department of Civil Service||Dispute Resolution Program||2011|
|North Carolina||Department of Insurance||Independent Review Organization||2013|
|North Dakota||Insurance Department||Independent Review Organization||2018|
|Ohio||Department of Insurance||Independent Review Organization*||2000|
|Oklahoma||Insurance Department||Independent Review Organization||2013|
|Pennsylvania||Department of Health||Certified Utilization Review Entity as UR Agent for MCOs||1999|
|Pennsylvania||Department of Health||Certified Utilization Review Entity for Independent External Reviews||1999|
|Pennsylvania||Insurance Department||Independent Review Organization Long Term Care||2011|
|South Carolina||Department of Insurance||Independent Review Organization||2019|
|South Dakota||Division of Insurance||Independent Review Organization||2010|
|South Dakota||Division of Insurance||Independent Review Organization Long Term Care||2010|
|Tennessee||Department of Commerce and Insurance||External Review Organization||2019|
|Utah||Insurance Department||Independent Review Organization||2011|
|Vermont||Department of Financial Regulation||Independent External Review Organization||2011|
|Vermont||Department of Financial Regulation||Independent Review of Long Term Care Benefit Trigger Determinations||2011|
|Virginia||Bureau of Insurance||Independent Review Organization||2011|
|Washington||Office of the Insurance Commissioner||Independent Review Organization||2005|
|Wisconsin||Commissioner of Insurance||Independent Review Organization||2009|
|Wyoming||Department of Health||Independent Review Organization||2010|
*d/b/a as Ohio Independent Review Organization
NMR goes above and beyond to deliver top quality work. I really value their time and effort they put into each case and appreciate their friendly staff reaching out to me with any questions or concerns. All my cases have been returned in a timely manner, which is of great importance to me.
Our company’s experience with NMR has been nothing short of remarkable. NMR offers an extensive panel of Specialty Physicians, quick turn-around-times, and detailed, quality reports. NMR is our “go-to” for uncommon specialty reviews. They regularly meet or exceed deadlines, and with superior quality results. What’s also nice is, their portal is user friendly and can be personalized to meet business needs. Above all, NMR’s staff and support are exceptional! They are readily available and responsive to questions/comments in a timely fashion. NMR offers innovative solutions for associated business challenges, and they are very accommodating to unique processes. No ask is too big or too small! We truly value our business relationship with NMR and the exceptional service they provide!
It has been amazing working with the NMR team. They are fully transparent in how they can help meet State and Federal requirements and always maintains an open line of communication. Exceptional customer service and a pleasure to work with. Highly recommend!
National Medical Reviews is an Independent Internal and External Medical Review Organization with URAC Accreditation. National Medical Reviews is certified by the Departments of Health & Human Services, Treasury & Labor as an Independent Dispute Resolution Entity.
Since 1996 NMR has been serving:
ERISA Regulated Benefit Plans ♦ Federally Regulated Agencies ♦ HMO ♦ Health Care Facilities ♦ State Agencies ♦ Insurance Companies ♦ Medicaid ♦ Medicare ♦ PPO ♦ PBMs ♦ Self-funded Plans ♦ State Insurance Departments ♦ Third Party Administrators ♦ Utilization Management Companies ♦ Workers Compensation