Services

AI Medical Peer Review Services

Faster, More Objective Medical Reviews with AI

Peer review is critical when it comes to ensuring the accuracy, necessity, and compliance of medical claims. At MOS Medical Record Reviews, we’ve reimagined the traditional process with AI-assisted peer review solutions. Our peer review system combines the precision of artificial intelligence with the expertise of licensed clinical reviewers—giving you the best of both worlds.

Benefit from intelligent and scalable services that are deeply aligned with your peer review objectives.

What Distinguishes Our AI Medical Peer Review Services?

Our AI-assisted peer review services streamline medical necessity assessments, support litigation strategies, and enhance claims decision-making with defensible, data-driven insights. Leveraging the power of AI in peer review, we provide insurers and health plans with automated, evidence-based assessments that reduce turnaround time, increase consistency, and improve decision-making across the board.

Ready To Transform Your Peer Review Process?

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We Ensure

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Faster Turnaround

We use advanced NLP and machine learning to quickly review large volumes of clinical data and identify discrepancies.

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Improved Accuracy

Our AI for peer review ensures objective evaluations that minimize reviewer bias and human error.

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Cost-efficient Compliance

Maintain regulatory and medical policy adherence while optimizing your claim review processes.

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Human Oversight Combined with AI Precision

Every AI-assisted peer review is validated by certified clinical experts to ensure integrity and fairness.

Advantages for Health Plans & Insurers and Insurance Attorneys

For Health Plans & Insurers

Accelerate prior authorizations and utilization reviews
Ensure compliance with CMS/NCCI and internal medical policies
Minimize fraud, waste, and abuse
Benefit from consistent, unbiased evaluations

For Insurance Attorneys

Receive well-documented, expert-reviewed medical opinions
Support litigation and settlement negotiations with credible evidence
Access quick reviews for time-sensitive cases or appeals
Enhance operational efficiency and legal preparedness

The Peer Review Process

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Upload the medical records securely. Our encrypted system ensures your data stays protected and confidential at every step.

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Our AI engine analyzes the medical data, extracting relevant diagnoses, treatments, and procedural justifications.

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Automated medical peer review AI evaluates the claim based on medical necessity, coding accuracy, and compliance.

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Our clinical reviewer validates the AI’s findings to ensure a sound, defensible decision.

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Final Report delivered with clear rationale and documentation.

“At MOS, we don’t replace clinical judgment — we strengthen it with precision and speed.”

Powered by ReviewGenX

At the core of our AI solution is ReviewGenX, our proprietary AI-driven platform designed specifically for advanced medical record review. Built on the DeepKnit AI framework and powered by our custom LLMs, ReviewGenX automates complex data extraction, identifies patterns of care, flags inconsistencies, and supports real-time decision making. Fully customizable and optimized for peer review workflows – it gives healthcare providers, attorneys and insurers excellent visibility, speed, and accuracy in every case.

Experience the Future of Peer Review – Powered by AI

Contact us to discover how automated medical peer review AI can transform your claims review process.

Call 1-800-670-2809

What Do Our Clients Think Of Us?

★★★★★

"MOS is a cost-effective service for reviewing and summarizing medical records. Their friendly and professional staff consistently provide prompt, accurate and reliable medical record review services."

Jason Ruiz

★★★★★

"MOS has made my life a lot easier. They are very cost-effective and Jan and the team offer the best customer service. Their turn around time is quite impressive too. Thanks for being so professional."

Jenay Price

★★★★★

"We have been using Managed Outsource for a while now for our medical reviews. They are always quick to respond and to get the reviews done. Easy to talk to and to work with. It is our pleasure working with this company. I highly recommend them to any one."

Donna Howe