Our physicians are trained in delivering evidence-based medical review services around various phases and requirements of medical claims management and can embrace all medical specialties to suit your needs.

NMR maintains dedicated teams of administrative personnel and clinicians for each line of business ensuring each claim received is handled and reviewed timely, appropriately and accurately. We ensure our products meet and comply with federal and state-specific quality and turnaround-time regulations and requirements in addition to the standards of our clients.

NMR’s broad network of physician specialists support our ability to service our clients across many lines of business including:

Disability

  • Short Term Disability (STD) Peer Reviews
  • Long Term Disability (LTD) Peer Reviews
  • Permanent/Total Disability (PTD) Peer Reviews
  • FMLA Clarifications (Self & Family)
  • Panel Peer Reviews

Group Health

  • Peer Review – Initial and Appeal
  • PPACA Appeal Review
  • State Level External Reviews
  • Cost Containment & Payment Integrity Reviews
  • Policy & Plan Ratification Reviews
  • Fraud, Waste and Abuse Reviews
  • Quality of Care Reviews

Liability

  • General Liability Peer Review
  • Employer/Employee Liability Peer Review
  • Auto Liability Peer Review

Workers’ Compensation

  • Medical Necessity Peer Reviews
  • Complex Pharmacy Reviews
  • Causation Reviews

Pharmacy Benefit Management

  • Workers’ Compensation
  • Group Health
  • Drug Utilization Reviews (DUR)
  • Formulary Exception Reviews