Claims Eval Inc. is a URAC accredited Independent Review Organization (IRO) with a national footprint. We provide independent, utilization reviews to ensure medically necessary, and quality health care.
We have a national panel of medical experts to help identify appropriate treatment which 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 benefit coverage matters.