Outsourced Utilization Review Management
We connect organizations with accredited UM review partners delivering fast turnaround, 99 percent first-pass accuracy, and consistent audit-ready results.
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Streamlining UM Workflows with Accredited Review Partners

PeerReviewService.com connects health plans with trusted, accredited Utilization Management review partners. Our network is vetted through a structured Quality Validation process to ensure accuracy, defensibility, and alignment with UM regulatory standards.

We help organizations reduce administrative burden, stabilize review operations, and maintain compliance even under rising regulatory demands.

  • 99 percent first-pass accuracy
  • Alignment with URAC, NCQA, and CMS UM requirements
  • 92 percent of cases completed within 48 hours
  • 100-plus specialties across medical and behavioral health

UM Review Services

Prospective, Concurrent, and Retrospective Reviews

Objective, evidence-based medical necessity and level-of-care determinations.

Behavioral Health UM

Psychiatric and substance use disorder reviewers for clinical accuracy.

Peer-to-Peer Outreach

High-success outreach with clear physician communication.

Medical Necessity Review Support

Determinations aligned to NCQA, CMS, and plan-specific criteria.

Complex Case Review

Expert support for escalated or multi-disciplinary cases.

Surge & Overflow Capacity

Scalable staffing to stabilize review backlogs and volume spikes.

Why Organizations Outsource UM

  • Improve accuracy through accredited review partners
  • Strengthen audit readiness and documentation quality
  • Reduce administrative burden and staffing challenges
  • Support P2P outreach and complex case handling
  • Maintain TAT adherence during fluctuating volume
  • Ensure specialty-matched clinical review coverage

FREQUENTLY ASKED QUESTIONS

Are your review partners accredited?

Yes. Our partners maintain accreditation or operate in alignment with URAC, NCQA, and CMS UM standards.

Prospective, concurrent, retrospective, behavioral health, complex case, and peer-to-peer.

Yes. Surge staffing and overflow review support are available.

Yes. We provide psychiatric and SUD review specialists.

Our partners cover over 100 medical and behavioral health specialties.

Strengthen Your UM Program

Request a consultation to get matched with an accredited UM review partner that fits your organization’s needs.