The Globe Newswire release says payers are weighing first-pass accuracy, turnaround times, accreditations and audit readiness more heavily than price alone when choosing review partners.
Healthcare payers are increasingly treating utilization management review as a strategic operating function rather than a low-cost administrative task, with vendor selection shifting toward measurable quality, speed, compliance support and scalability. The release says health plans, managed care organizations, third-party administrators and other healthcare organizations now focus on factors including first-pass clinical accuracy, turnaround performance, peer-to-peer physician outcomes, reviewer coverage, accreditations and information security, because weak review quality can raise appeals volume, compliance risk, provider friction and administrative costs. BHM Healthcare Solutions, described as an independent review organization, presents itself as an example of that quality-first model. The company says its framework includes 99.9% first-pass review accuracy, 99.8% on-time turnaround, more than 90% peer-to-peer physician success, average turnaround of about 24 hours, urgent reviews completed in as little as 30 minutes, reviewer coverage in all 50 states, NCQA Accreditation, URAC Accreditation and HITRUST Certification. It also cites a proprietary 17-Point Quality Validation Process aimed at clinical consistency and audit readiness. Eric Rosenberg, President of BHM Healthcare Solutions, said healthcare organizations need review partners that act as an extension of their own teams, adding that quality, responsiveness, clinical integrity and operational partnership help plans deliver better outcomes for providers and members. The release frames the broader trend as an industry move toward evidence-based vendor evaluation, where the key question is no longer whether a vendor can perform reviews, but whether it can maintain quality at scale and defend decisions during audits and appeals.