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MMRO Achieves URAC AI in Health Care Accreditation

In a significant milestone for the healthcare industry, Managed Medical Review Organization, Inc. (MMRO) has announced its attainment of the Artificial Intelligence in Health Care Accreditation (Version 1.0) from URAC, a leading independent health care accreditation body in the United States. This newly launched accreditation program is the first of its kind to establish trustworthy standards for the responsible development and application of artificial intelligence (AI) in healthcare settings.

Over the past year, MMRO has dedicated considerable efforts to formulate a thorough AI governance program tailored to the complex demands presented by AI technologies. This program encompasses responsible usage policies, comprehensive risk assessments, and impact evaluations that address the distinct challenges related to data security. Furthermore, the program incorporates extensive testing and training requirements aligned with URAC's stringent criteria, ensuring comprehensive oversight throughout the process. Clinical supervision is spearheaded by MMRO’s Vice President of Clinical Programs, Jen Mongeau, DHA, MBA, MSN, RN, reinforcing the organization's commitment to clinical integrity and excellence.

Douglas Minke, J.D., M.B.A., Vice President of Corporate Development and General Counsel for MMRO, emphasized the dedication and hard work that led to achieving this prestigious accreditation. “This accreditation was the result of a full year of preparation and effort, and our team should be incredibly proud,” he stated. The newly established governance framework enables MMRO to critically evaluate emerging AI technologies with a focus on two pivotal questions: does it protect the information we review and the individuals we serve, and does it maintain the clinical excellence standards that our clients expect? If the answer to either question is no, the technology will not be pursued.

The insights gained through the URAC Accreditation will empower MMRO to further investigate AI solutions that can enhance the efficiency and clinical accuracy of services provided to clients. Notably, the organization maintains a commitment to using AI technologies responsibly and in compliance with the highest standards. MMRO firmly states that AI tools will not be employed to make clinical judgments, assess medical necessity, render clinical determinations, replace legal oversight, or function as independent decision-makers in potentially detrimental scenarios involving members, claimants, patients, providers, or employees.

“Our motto, Growth Through Quality, transcends mere words; it profoundly shapes our decision-making landscape,” asserted Joe Schimizzi, President and CEO of MMRO. He acknowledged the integral role of the MMRO staff, highlighting their expertise, care, commitment, and relentless pursuit of clinical excellence in every aspect of their work. The achievement of the Artificial Intelligence in Health Care Accreditation from URAC not only underscores the organization's commitment to quality but also reassures stakeholders that as MMRO grows and embraces AI technology, it will steadfastly prioritize clinical quality above all else.

This prestigious accreditation complements MMRO's longstanding position as an Independent Review Organization (IRO), a status it has maintained for over 15 years through URAC.

About MMRO

Managed Medical Review Organization, Inc. (MMRO) is headquartered in Novi, Michigan, and specializes in providing independent medical review services, buoyed by one of the largest networks of licensed physicians and clinical professionals nationwide. With a resolute focus on security, compliance, and service excellence, MMRO operates under the guiding principle of Growth Through Quality, delivering timely and scientifically sound reviews that align with the highest industry standards. To learn more, visit www.mmroinc.com.