Health Utilization Management
MedManagement, LLC holds itself to a higher standard of governance and operations as evidenced by its achievement of URAC accreditation for Health Utilization Management. The organization and each individual are expected to conduct all affairs with honesty, integrity and in accordance with MedManagement’s mission, core values and ethical standards. Policies, procedures and operations promote a culture of exemplary, ethical conduct. Quality work is not an abstract expectation; it is defined, measured, and monitored. We focus on continuous quality improvement in all aspects of our performance. Adherence to a national, verifiable standard is important when working and communicating with auditors to demonstrate independence and objectivity, and to establish credibility. MedManagement accomplishes this through URAC accreditation.
Independent Review Organization
MedManagement is also URAC accredited as an Independent Review Organization (IRO). Independent Review Organizations that achieve URAC accreditation are committed to a fair and impartial medical peer review process that benefits both patients and physicians. The URAC accreditation is designed to assure that Independent Review Organizations are free from conflicts of interest, establish qualifications for each physician performing independent medical peer review, address medical necessity and experimental treatment issues, have reasonable time periods for standard and expedited peer reviews and appeals processes.
Microsoft Certified Partner
MedManagement, LLC is recognized by the Microsoft Partner Network as having Silver Application Development Competency.
HIPAA EDI (Electronic Data Interchange) Compliant
The HIPAA Electronic Data Interchange rule requires all entities that electronically transmit PHI (personal health information) data to do so in accordance with the X12N EDI data transmission protocol standard. MedManagement supports and maintains compliance with this rule that was designed to allow both Medicare and health care providers to “process transactions faster and at a lower cost.” (CMS.gov web site / Electronic Billing & EDI Transactions).
National Association of Independent Review Organizations (NAIRO) Member
According to the NAIRO web site: “The National Association of Independent Review Organizations (NAIRO) was formed by the majority of URAC-accredited independent review organizations (IRO). NAIRO is comprised of 32 members and is dedicated to protecting the integrity of the independent medical peer review processes. Utilizing the expertise of thousands of board-certified clinicians throughout the country, NAIRO members embrace an evidence-based approach to independent medical peer review, in order to help resolve coverage disputes between enrollees and their health plans.”