Dedicated to Quality. Committed to Objectivity.

Independent Review Organization/Medical Reviews

MET is an Independent Review Organization (IRO) accredited through URAC, a non-profit organization that helps promote health care quality through standards that validate organizations are committed to a fair and impartial medical review process that benefit both patient and physician appeals.

URAC accredited IROs undergo a thorough screening process to ensure health plans and consumers receive a comprehensive review and objective appeal decision.

We provide nationwide Independent Medical Review services for state insurance departments, group health plans, worker’s compensation, utilization review companies, hospitals, employers, benefit administrators, attorneys, and casualty insurers.

Our peer reviews are free from conflict and performed by highly-trained, unbiased legal professionals, board-certified physicians, and qualified healthcare providers, in compliance with specific state, federal, and URAC mandates.

Utilizing an evidence-based decision process, our peer reviews reduce both administrative costs and liability while improving member satisfaction.

Independent Medical Review and Appeal Services:

First Level Review

We review whether an initial request for a medical service or treatment is medically necessary or experimental/investigational. As a URAC-accredited IRO, we maintain higher industry standards for validating your review through our team of medical professionals resulting in significant cost savings and enhanced member satisfaction.

Internal Medical Appeal (Second Level Review)

When a first level review is denied, one may wonder if the denial was rushed or biased. Outsourcing your second level review to MET's URAC-accredited IRO team of physicians, who are active in the specialties being discussed, will provide you with an unbiased second level review, enhancing member satisfaction.

External Review

When one has exhausted the internal review process, an external review can be requested to determine whether the denied medical treatment is medically necessary or experimental/investigational. MET's URAC-accredited IRO team can provide an unbiased external review, using physicians who currently practice in the specialties under review, for institutions that fall outside the State's IRO coverage, helping to enhance member satisfaction.

Contractual (health plan) Appeal

Our team of lawyers conducts reviews regarding the rescission of benefits, benefit interpretations, reimbursement issues, and other administrative/legal concerns to determine if a plan was applied appropriately. Consult with our legal team to determine next steps in your health plan appeal.

Legal Review

Our team of certified auditors and physicians provide the evidence necessary to validate your case. When your legal team needs an expert medical opinion, we have the answer. Our legal team is ready to assist you in organizing the evidence in a professional manner.

Second Opinion Review

When the first opinion isn't quite powerful enough, our second opinion review team of board-certified physicians will assemble a defensible medical opinion for validating medical necessity and appropriateness of proposed treatments or services.

Quality of Care Review

Hospitals, long-term care centers, and healthcare providers work hard to promote the effective, efficient, and economical delivery of health care services. Using our team of medical professionals, we review whether the quality of care met professionally-recognized standards.

Compensability/Early Assessment

Our team of medical experts, through a comprehensive evaluation of the medical evidence supported by objective findings, defines the appropriate limits of the claimed injury, thereby reducing the amount spent on non-compensable medical treatment. To begin the process of saving money, call us today!

Long Term Disability Reviews

Outsourcing your long term disability reviews to MET may reduce the likelihood of future appeals. Allow our board-certified physicians to provide objective medical opinions on an individual’s medical status and functional abilities based on medical evidence.

Pharmaceutical Review

Our pharmaceutical review team will conduct a comprehensive review to help you determine if your results are optimal.

Radiology Review

Obtain crucial radiological interpretations from our team of board-certified radiologists, using our state-of-the-art secure platform, which is capable of handling large, memory-intensive image files quickly and efficiently. Start your radiology review today.

Medical Director Consultation

Our medical director consultants provide reviews of current policies, verify the credibility of your peer review program, design medical protocols, assist with program development, and perform health audits. To learn more about our medical director consultants, call us today.