Review Services

AllMed provides comprehensive clinical review services supporting the needs of leading payer organizations. Our broad portfolio spans a continuum from prior authorizations to external appeals and medical director services.

Portfolio of Clinical Review Services

Utilization Management

Evidence-based reviews to ensure the highest level of appropriate care

Nurse Reviews

Timely, accurate utilization reviews to help you scale quickly to meet fluctuating demand

Physician Generalist Reviews

Nurse and physician reviews to augment your internal capabilities

Specialist Reviews

Specialized expertise for
standard of care and complex procedures

Appeals

High-quality decisions by specialists delivered to the standards you expect

External Appeals

Compliance-driven reviews that meet federal and state requirements

Specialty Knowledge When You Need It

We partner with the most qualified physicians, in all major specialties, ensuring you get the highest level of expertise today and the latest knowledge as it becomes available. All our physicians are board-certified and remain in active practice.

Medical professional graphic

350

Active
Peers

Certification graphic

120

Specialties &
Subspecialties

Health plans@2x

99%

Cases Completed By
Preferred Specialty

Expertise End to End

AllMed’s panel of nurse and physician reviewers provide clinical expertise to cover more than 120 different specialties and subspecialties. Applying their expertise and in-depth knowledge at the beginning of the UM process fosters accurate medically necessary approval or denial—reducing the potential need for costly appeals or additional treatments if medical care is delayed.

Our UM services for prospective, concurrent, and retrospective prior authorization and appeals span initial clinical review, physician review, peer-to-peer communication, and determination notification letters— from the most straightforward prior authorization to the most complex appeal.

We know how important turnaround time (TAT), quality, and customer service are to you, and we make them a priority. Over 98 percent of our cases are reviewed and completed before our contractual times, helping you increase responsiveness and decrease overall costs. And all our UM solutions, including prior authorization reviews, are designed to facilitate integration with your clinical operations workflow through AllMed’s PeerPoint® advanced medical review portal.

Reach Out
Interested in our Review Services?

Whether you need specialized expertise or added review capacity,
we’re here to help with customized services that fit your exact needs.

Accreditations