H.H.C. Group Awarded Multi-State Approvals to Conduct Independent Medical Reviews, Delivering Critical Value to Payors

/EIN News/ -- ROCKVILLE, Md., May 06, 2025 (GLOBE NEWSWIRE) -- H.H.C. Group (H.H.C.), a leader in reducing healthcare costs by providing high-quality cost containment using claim negotiation, repricing and independent review solutions, announces that it has been re-approved by multiple states in which it currently conducts Independent Medical Reviews (IMRs), typically for disputes regarding coverage by payors based on medical treatment necessity or appropriateness. These state designations reinforce H.H.C.’s position as a URAC-accredited Independent Review Organization (IRO) and highlights the company’s vital role in helping payors resolve claim disputes efficiently, compliantly and with clinical precision.

“Acceptance by 32 states positions us as a trusted partner from coast-to-coast,” says Bruce D. Roffé, president and CEO, H.H.C. Group. “In most states, once a coverage denial occurs, insurers must refer the case to the state, which assigns it to an approved IRO. In others, insurers can contract directly with an IRO like H.H.C.—and we are fully equipped to support both pathways. Additionally, numerous insurers have H.H.C. help them determine if they should cover a treatment requested by a plan enrollee.”

H.H.C. Group’s peer review panel includes board-certified physicians and healthcare professionals across 84 specialties and subspecialties, ensuring every review is grounded in appropriate clinical expertise. As a URAC-accredited IRO, H.H.C. upholds the highest standards for reviewer credentials, timeliness, and impartiality—essential in today’s highly regulated environment.

“With regulatory scrutiny growing and medical necessity and appropriateness determinations under increased pressure, H.H.C. Group’s IMR capabilities offer payors a trusted way to uphold clinical integrity, meet compliance demands, and avoid unnecessary litigation,” continues Roffe. “This isn’t just about regulatory approval—it’s about helping our clients fairly and effectively meet the needs of plan enrollees. We provide payors with a partner that delivers clarity, compliance and clinical credibility when it matters most.”

H.H.C. Group IMRs offer several benefits, including protecting patients, improving internal review processes, and potentially reducing litigation. They also play a crucial role in ensuring compliance with healthcare standards and can help payors streamline their processes by optimizing resource utilization and decision-making. 

About H.H.C. Group  
Dedicated to significantly reducing medical claims costs through claim negotiation, repricing and independent medical review, H.H.C. Group is a national healthcare cost-containment leader serving self-funded healthcare payors, TPAS, stop-loss carriers/captives, unions and insurers. Serving the Group Health, Workers Compensation and Auto-Health markets, H.H.C. Group delivers timely, customizable solutions and proven savings. Committed to integrity and compliance, URAC-accredited H.H.C. Group stands out as a trusted partner for reducing healthcare costs and ensuring quality outcomes.

Media:  
Brittany Tedesco
CPR Marketing
btedesco@cpronline.com  
201-641-1911x14