Independent Medical Review

To learn more, contact:
Conni Brandt
Vice President of Review Services and Performance Measurement
1-800-362-2320 or 1-608-274-1940, ext. 8209

MetaStar conducts independent medical case review for providers and health plans upon request. MetaStar’s pool of nurse and physician reviewers perform a thorough review of medical records to assure that medical care delivered met professionally recognized standards of care.

Types of Review

  • Quality
  • Credentialing
  • Risk Management
  • Utilization Management
  • Diagnosis-related group (DRG)/Coding Validation

What makes our service unique?

  • MetaStar has 40 years of experience providing medical review for the Centers for Medicare & Medicaid Services (CMS) in Wisconsin
  • MetaStar has served as the External Quality Review Organization (EQRO) for Wisconsin since 1973, providing medical review as part of this role
  • Our physician reviewers are in active practice, board-certified and span 35 specialities
  • Our nurse reviewers have clinical experience and years of experience in case review. They are thoroughly trained in review procedures and proficient in evidence-based guidelines.
  • Confidentiality and security of your records are our top concern. We have established processes to ensure confidentiality and we use a secure file transfer system for all medical record files.

 

What our customers say:

100% of independent medical review customers in 2014 said they would recommend MetaStar to a colleague.