MCMC’s Independent Peer Review program compliments your appeal, claims, prior-auth, utilization, and case management programs by providing the comprehensive physician expertise and driven service delivery you need to meet industry and regulatory standards for medical review. MCMC’s range of services includes everything from pre-certification reviews to complex, high-tech policy reviews, and for health plans, insurance carriers, pharmacy benefit managers, self-funded employer groups, third-party administrators, hospitals, and state-mandated external review programs. Independent Peer Review Turn to the source that most health plans rely on for their peer review services. MCMC is the source you can trust to provide premier service for all your peer review needs. Peer Review Services • Pre-certification/prior authorization • Retrospective • Appeals • Concurrent • Fraud and abuse • Telephone conference/consultation • Quality assessments • Medical expert testimony • Criteria review • Legal Review • Clinical trials MCMC reviews address the following issues: • Medical necessity • Covered benefits based on plan language • Experimental or investigational procedures • Level of care • Drug formulary compliance • Employee leave assessment • Alternative treatments • Length of stay • Impairment, work restrictions and limitations • Procedural coding”
View Top Employees from MCMCWebsite | http://www.mcmcllc.com |
Revenue | $186 million |
Employees | 520 (293 on RocketReach) |
Founded | 1988 |
Address | 1451 Rockville Pike Suite 440, Rockville, Maryland 20852, US |
Phone | (800) 227-1464 |
Fax | (617) 375-7777 |
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Industry | Hospital & Health Care, Management Consulting, Health Care, Business Services, Hospital |
Web Rank | 2 Million |
Keywords | Medical Case Management, Healthcare, Medical Cost Containment, Utilization Management, Healthcare Quality |
Competitors | CorVel Corporation, EK Health Services Inc., ExamWorks, Medata, Rising Medical Solutions |
SIC | SIC Code 738 Companies, SIC Code 73 Companies |
NAICS | NAICS Code 54 Companies, NAICS Code 541 Companies, NAICS Code 541611 Companies, NAICS Code 5416 Companies, NAICS Code 56 Companies, NAICS Code 54161 Companies |
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The MCMC annual revenue was $186 million in 2024.
Paul Lanning is the Senior Vice President - Sales of MCMC.
293 people are employed at MCMC.
MCMC is based in Rockville, Maryland.
The NAICS codes for MCMC are [54, 541, 541611, 5416, 56, 54161].
The SIC codes for MCMC are [738, 73].