Michigan Peer Review Organization

For more than 40 years, iMPROve Health has advanced high-quality, cost-effective healthcare through research, data analysis, innovation, and collaboration. As a partner in the Superior Health Quality Alliance, iMPROve Health serves as the Quality Innovation Network-Quality Improvement Organization supporting CMS quality improvement initiatives across Indiana, Illinois, Michigan, Minnesota, Ohio, and Wisconsin. This work supports our charitable, educational, and scientific purpose by lessening the burdens of government and promoting health through quality improvement activities under Part B of Title XI of the Social Security Act, as amended, to improve the quality, safety, and value of healthcare.

The No Surprises Act, effective January 1, 2022, protects consumers from certain unexpected out-of-network medical bills, or "surprise bills." It also created an independent dispute resolution process for payment disputes between plans and providers, as well as options for uninsured and self-pay individuals whose bills substantially exceed provider good faith estimates. As a leading IDR entity, iMPROve Health provides fair, efficient, and compliant arbitration services, including case management, arbitrator assignment, evidence review, compliance oversight, and customized reporting. This work supports our charitable, educational, and scientific purpose by lessening the burdens of government and promoting health through peer review of the reasonableness, medical necessity, appropriateness, and quality of healthcare services, and by rendering payment determinations for those services.

For more than 40 years, iMPROve Health has helped advance healthcare quality nationwide. As an Independent Review Organization, iMPROve Health provides impartial, data-driven, and comprehensive review services through experienced professionals and clinical peer reviewers. The organization delivers timely, objective external reviews for hospitals, third-party payors, health plans, and state insurance departments nationwide and has maintained full URAC accreditation as an Independent Review Organization since 2002. This work supports our charitable, educational, and scientific purpose by advancing healthcare review, quality improvement, education, and research to improve the safety, quality, accessibility, availability, and efficiency of healthcare.