Specialty-Matched Independent Appeals

Some health plan and payer organizations rely on their own internal physician advisors and medical directors to manage first and second-level appeals. However, as the pressure to reduce costs, improve quality, and avoid conflicts of interest increases, more and more payer organizations are turning to AllMed to manage their clinical decision-making processes.

By utilizing our Independent Review Organization (IRO) services, you can focus on your core competencies while entrusting us to support your clinical decision making. At AllMed, we have the expertise and resources to manage the rigorous tasks of physician specialist credentialing, performance management, quality oversight, and scalability required in today’s hyper-competitive landscape.

All of our reviews are conducted by board-certified physician specialists and sub-specialists who are actively practicing. Every appeal review is carried out in compliance with URAC, NCQA, CMS, state, and other federal regulations, all of which are subject to oversight and audit through our Quality and Compliance programs.

At AllMed, we understand the importance of making sound clinical decisions, while maintaining the highest standards of quality and compliance. By relying on our IRO services, you can rest assured that your appeals and clinical decision-making processes are in good hands. With our expertise and resources, we can help you navigate the increasingly complex landscape of healthcare, while maintaining the highest levels of quality and efficiency.

All of our services are deployed through PeerPoint, AllMed’s advanced medical review portal, which embeds healthcare intelligence and automation tools that produce the highest quality reviews at industry-leading turnaround times and costs.

But what really makes us different is our people. Our commitment to consistently exceeding our clients’ expectations through everything we do, is why AllMed’s clients remain loyal partners, year-after year. This is because of the special care we take to recruit the highest quality talent as well as train, grow and engage them in our Lean management system. As a values-based company that puts culture first, our employees care deeply about each member’s health and about delivering the highest quality care.