Claims Eval Inc. is a nation-wide URAC accredited Independent Review Organization (IRO). We provide independent, external utilization reviews to ensure medically necessary, quality health care.
We have a broad panel of medical experts to help identify appropriate treatment plans that conform to state and national mandates.
As an IRO, we work with Utilization Review companies, Utilization Management companies, hospital Utilization Management departments, Workers’ Compensation and Group Health insurance companies, disability management and medical cost containment companies, third-party administrators, and self-funded employee benefit payors. We provide state-mandated independent reviews for workers’ compensation and group health plans, addressing medical necessity, investigational/experimental treatments, clinical trial participation, and contractual/administrative matters.