Payer Best Practices

BHM Healthcare Solutions

Pursuing excellence when serving our clients and
helping deliver high-quality and cost-effective care since 2002.

Meet Our Leadership Team

about BHM

Eric Rosenberg


about BHM

Mary McCormick


about BHM

Eric Duchinsky


about BHM

Rayliz Torres

Compliance & HR

about BHM

Jessica Dees


Our Purpose and Passion

Meet or exceed client requested
turnaround times and
deliver accurate results.

Utilization Management

Network Coverage

BHM’s reviewer network represents a vast array of specialties and sub-specialties.


Continuous self-auditing of reviewer performance for meeting client expectations.


BHM’s turnaround time (TAT) commitment raises expectations for delivering accurate results.


IRO Coordinators oversee reviewers adding the human touch to performance metrics.

What Is An Independent Review Organization (IRO)?

“An independent review organization (IRO) acts as a third-party medical review resource which provides objective, unbiased medical determinations that support effective decision making, based only on medical evidence. IROs deliver conflict-free decisions that help clinical [patient care] and claims management professionals better allocate healthcare resources.” 
– National Association of IROs

How Can My Organization Benefit From an IRO?

Good question. Whether your organization is a health system or insurance company, IROs often build value by

  • Providing access to networks of doctors specializing in unique and complex care.
  • Lowering the cost of maintaining and recruiting in-house medical subspecialties and behavioral health experts for reviews.
  • Building more efficient, independent support for applying medical necessity criteria

Why Choose BHM Healthcare As My IRO?

Glad you asked, because BHM stands apart from most IROs in a number of ways.

Below are just a few. Hover over each and see how they benefit organizations, like yours:

What are the 3 components of utilization review?

Utilization review contains three types of assessments: prospective, concurrent, and retrospective. BHM expertly handles all aspects, including appeals.

Utilization Management

Proven History of Quality

BHM earns the most respected credentials needed for delivering the best client results.

Payers and providers know the URAC, NCQA, and HITRUST brands and their high-bar quality requirements. Our credentials fit hand in glove with your organization’s expectations.

independent review organization
NCQA Accreditation Experts

Our client team is extremely qualified to help lift
your organization to new heights

Our client team is extremely qualified to help lift
your organization to new heights

about BHM

Mary McCormick

VP of Sales &
Account Management

Phone: (888) 831-1171 x144
Cell: (612) 749-2426

Alyssa Vazquez

Sales & IROC

Office: (888) 831-1171 x027