MCMC provides independent, objective, and credible information for healthcare decision-making for health plans, patients (consumers), purchasers, payors, business partners, agents, and providers by providing quality, timely, cost-effective independent medical reviews, managed care services, and related services.
MCMC offers physician and Allied Health specialist reviews serving National Group Health Insurance Carriers, Third-Party Administrators (TPA), Disability/IME carriers, Pharmacy Benefit Managers (PBM), Government and State agencies, Special Investigation Units (SIUs), Hospital Quality and Compliance, and Workers’ Compensation.
MCMC is a Certified IDR Entity!
The "No Surprises Act" creates new protections against out-of-network balance billing and establishes a new process, called the independent dispute resolution process, which providers, emergency facilities, and health plans can use to resolve payment disputes for certain out-of-network charges.
The Department of Health and Human Services, the Department of Labor, and the Department of Treasury have certified MCMC Services, LLC to serve as an independent dispute resolution entity in the federal independent dispute resolution process between providers, facilities, or providers of air ambulance services and group health plans, health insurance issuers, and Federal Employees Health Benefits program carriers.