Managed Medical Review Organization

What Managed Medical Review Organization does

Managed Medical Review Organization, Inc. (MMRO) is a privately held, for-profit Independent Review Organization headquartered in Novi, Michigan, that delivers independent medical peer review and disability management services to enterprise and government clients across the United States. The company operates two integrated service lines: Disability Management (pre-claim administration, clinical case management, physician review services including STD/LTD peer review, medical board reviews, peer-to-peer communication, multi-disciplinary panel reviews, and evaluation services such as IME, IPE, FCE, vocational assessments, and FMLA assessments) and Healthcare Review (URAC-accredited IRO services covering medical necessity and appropriateness reviews, experimental/investigational determinations, utilization review, internal and external appeals, quality of care review, No Surprise Act external reviews, and clinical guideline/medical policy reviews). Service delivery is supported by a nationwide multi-specialty physician reviewer network covering over 80 specialties, staffed by board-certified actively practicing clinicians.

The underlying technology stack consists of web-based case management platforms — the MMRO Access Point Portal (MAP) and CoreConnect — used for case intake, scheduling, document submission, and review delivery, backed by an IT Helpdesk ticketing system. MMRO maintains complex password authentication with 90-day expiration and TLS 1.1+ encryption, annual-tested disaster recovery including on-site backup generation, keycard and 24-hour video surveillance at the headquarters, and SOC2 Type 2 audited internal controls alongside HIPAA compliance through Business Associate Agreements. The company holds full URAC accreditation as an Independent Review Organization for both internal and external comprehensive reviews and is an active member of the National Association of Independent Review Organizations (NAIRO).

MMRO generates revenue under a professional services model through direct enterprise sales to managed care organizations, group disability carriers, commercial and self-insured health plans, pharmacy benefit managers, third party administrators, Medicare/Medicaid programs, government agencies, and state/county/municipal retirement systems. Pricing is not publicly disclosed and is presumed to be quote-based and negotiated per enterprise contract. The company is led by President & CEO Joe Schimizzi with a credentialed executive team including a DHA/MBA/MSN/RN Vice President of Clinical Programs, a JD/MBA Vice President of Corporate Development & General Counsel, and a CDMP-certified Vice President of National Sales & Marketing. MMRO has no disclosed parent company, private equity sponsorship, or institutional investment, and operates as an independent entity with 101-250 employees.

Name

Managed Medical Review Organization

Legal name

Managed Medical Review Organization, Inc.

Website

https://mmroinc.com

Company type

Private

Founded year

2007

Operating status

Operating

Headcount range

51–100 employees

Short description

MMRO is a URAC-accredited Independent Review Organization providing independent medical peer review and disability management services to managed care organizations, disability carriers, government agencies, employers, and TPAs across the United States.

Ownership category

akta.pro rank

Product category

Independent Medical Review Services

NAICS

Services for the Elderly and Persons with Disabilities (624120)

SIC

Services-Specialty Outpatient Facilities, Nec (8093)

akta.pro primary industry

Second Opinion & Expert Medical Review Platforms (HLALADAI)

akta.pro secondary industry

Quality, Peer Review & Compliance Tools (MQSA/ACR/QA) (HLACALAL)

Keywords

• Medical peer review
• Independent review organization
• Disability management
• Healthcare utilization review
• Clinical case management

Headquarters

HQ city

Novi

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Medical Peer Review Services: Independent medical peer review services for healthcare organizations, insurance carriers, and government agencies requiring objective, evidence-based clinical reviews for medical necessity, appropriateness, and appeal determinations.
2. Disability Management Services: Administrative and clinical disability management services including pre-claim administration, clinical case management, and physician review services for short-term and long-term disability claims.

Go-to-market motion1 record

Distribution channels2 records

Marketing channels3 records

Core offering

MMRO provides independent medical peer review and disability management services through a URAC-accredited Independent Review Organization (IRO). The company delivers evidence-based clinical reviews for medical necessity, appropriateness, appeals, and utilization decisions, as well as administrative and clinical disability management services for short-term and long-term disability claims. Services are supported by a multi-specialty physician reviewer network covering 80+ specialties and delivered through secure web portals.

Product overview

MMRO is a unified medical peer review and disability management platform. The company offers two primary service lines: Healthcare Review (URAC-accredited IRO services for medical necessity, appeals, and clinical reviews) and Disability Management (administrative, clinical, and physician review services for disability claims). These services are delivered through secure web portals including MMRO Access Point Portal (MAP) and CoreConnect, supported by an IT Helpdesk. MMRO's multi-specialty physician reviewer network covers over 80 specialties nationwide.

Differentiator

Problem solved

Functional benefit

Brands

• MMRO Access Point Portal (MAP): Secure web portal for accessing MMRO services
• MMRO IT Helpdesk

Products and services

• Disability Management Administrative and clinical disability management services including Pre-Claim Administration, Clinical Case Management, Physician Review Services (Medical Board/Advisor Reviews, STD and LTD Peer Review, Peer-to-Peer Communication, Multi-Disciplinary/Panel Reviews), and Evaluation Services (IME, IPE, FCE, Vocational Assessments, FMLA Assessments). For group disability carriers, employers, and third-party administrators.
• Healthcare Review URAC-accredited Independent Review Organization (IRO) services providing medical peer review including Medical Necessity/Appropriateness reviews, Experimental/Investigational determinations, Peer-to-Peer reviews, Utilization Review (preauthorization, retrospective, concurrent), Appeal Review (internal and external), Quality of Care Review, No Surprise Act External Reviews, and Clinical Guideline/Medical Policy Reviews. For managed care organizations, commercial health plans, Medicare/Medicaid, and pharmacy benefit managers.
• MMRO Access Point Portal (MAP) Secure web portal for enterprise clients to access MMRO case management services, submit case requests, schedule reviews, and manage documents. Accessed via valid User ID and password credentials granted by authorized representatives, with complex password requirements and TLS 1.1+ encryption.
• MMRO IT Helpdesk Support portal enabling clients to submit support tickets and communicate concerns regarding security breaches or service issues with MMRO systems.

Named customers7 records

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Scale indicators2 records

Recent moves5 records

Expansion highlights4 records

Direct peers

• AllMed Healthcare Management: Independent medical review organization providing peer review, utilization review, and external appeal services to payers and providers. Closely comparable to MMRO as a URAC-accredited IRO serving health plans, TPAs, and government programs.
• Advanced Medical Reviews: Independent Review Organization offering medical necessity, appeals, and peer review services to health plans, managed care organizations, and government agencies. Directly comparable in service mix, accreditation posture, and target buyer to MMRO.
• Medical Review Institute of America (MRIoA): Independent peer review company delivering utilization, medical necessity, and external appeal reviews to payers, providers, and government entities. Closely aligned with MMRO in service lines, accreditation, and enterprise B2B GTM.
• MCMC: Independent medical review and case management organization serving insurers, employers, attorneys, and government agencies. Comparable to MMRO in offering peer reviews, IMEs, and disability-related clinical reviews.
• Dane Street: Medical peer review and IME provider focused on workers' compensation, disability, and auto markets. Closely comparable to MMRO in the disability and impairment evaluation segment of its business.
• Permedion (HMS, an Elevance Health company): Medical review services organization delivering utilization management, peer review, and quality reviews for Medicaid and commercial payers. Comparable to MMRO's healthcare review line and government program exposure.

Broad incumbents

• eviCore healthcare (Evernorth, Cigna): Large-scale utilization management and specialty benefit management company within Cigna's Evernorth services arm. Overlaps with MMRO on utilization review, medical necessity, and appeals but at far greater scale and broader scope.
• Cotiviti: Healthcare payment accuracy and review analytics company serving payers across claims editing, clinical review, and quality. Adjacent to MMRO's review services but operates at much larger scale with a broader analytics portfolio.
• Sedgwick: Large global provider of disability, absence management, and claims management services to employers and insurers. Overlaps with MMRO on the disability management side as a broad incumbent offering integrated disability programs.

Others

• Maximus: Government services and program administration company operating Medicaid, Medicare, and other health-related programs. Comparable to MMRO in serving government health programs with independent review and clinical support services.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/mmroinc

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Managed Medical Review Organization