URAC Accreditation Exceeds 20 Years

In August 2024, URAC provided notice to CIMRO of FULL Accreditation pursuant to the Independent Review Organization (IRO), External Review 6.0 Program, for the maximum three-year period (September 1, 2024, to September 1, 2027).
Notably CIMRO has been URAC accredited for more than 20 years.  We were first accredited by URAC from 2001 to 2009 as a Health Utilization Management (HUM) organization, and then as an IRO since 2009. 
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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 providing direct clinical care to patients and managing the medical condition, procedure, treatment, or issue under review within the past 3 years. 
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IRO services are provided to state departments of insurance and health and self-funded plans for member appeals of health care services that have exhausted the health plan's internal appeals processes, including denials due to:

• Medical necessity 
• Experimental/investigational
• Pre-existing condition/rescission of health coverage