Holding Ourselves to Highest Standards - URAC Accreditation Exceeds 20 Years

CIMRO was first accredited by URAC from 2001 to 2009 as a Health Utilization Management (HUM) organization, and then as an Independent Review Organization (IRO) since 2009. 

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We are currently in the reaccreditation process under the IRO, External Review 5.2 Standards for another three-year cycle. The rigor of the accreditation process confirms our processes meet industry best practices.  

Physician reviewers involved in IRO reviews must have at least 5 years’ experience managing the medical condition, procedure, treatment or issue under review within the past 3 years. 
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Independent Review Organization services are provided to state departments of insurance for member appeals of health care services that have exhausted the health plan's internal appeals processes, including denials due to:
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• Medical necessity 
• Experimental/investigational
• Pre-existing condition/rescission of health coverage

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