A Federal External Review standard time frame.

The member and authorized representative receive this for all expedited external appeals.

All Independent Reviewers are required to maintain these during their tenure with MMRO, including meeting the continuing education requirements, if required.

This type of review determines eligibility of a request for external review.

Questions and specialties are chosen here.

This eligibility review service must be completed within three business days for most clients.

The client/health plan is the only party to receive the report for all types of reviews except for this one.

Any reviewer must have at least this many years of current clinical experience to join our panel.

This is the only level of service where there will be contact with the member and authorized representative, if applicable.

This is where you would generate a report template

This must be sent to the health plan and reviewer, if applicable, within one business day of receipt.

Peer to peer calls require this many attempts, on different days and at different times.

If these aren't a part of your report template, they must be sent separately to the reviewer for signature for every case review.

The determination for this level of review will be either Approve or Deny.

You deliver your final product when your case lands in this bucket.

This initial correspondence notifying the member that MMRO has been assigned to their case must be sent out within one business day.

The member, authorized representative and health plan receive an index of materials letter for these state departments of insurance.

This state department of insurance requires that any physician conducting a review through them must be credentialing by them prior to sending the case.

The IRO drives the entire process for this level of review.

An Index of Materials Letter is created in this bucket.

This service has an expedited time frame of 24 hours.

Upon finalization of a federal external review, this gets issued alongside the final report.

An MMRO Reviewer goes through this process every 3 years.

This type of service is initiated by a client in order to evaluate the performance of an attending physician.

If you are waiting on a reviewer's approval of edits, look for your case here.