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Welcome to Meridian Health Systems ACO Corporation

Meridian Health Systems ACO Corporation is a Premier Nationwide Accountable Care and Independent Medical Review Organization with over 700 contracted participants, professionals, providers and suppliers located in 50 states including the District of Columbia and managed by Meridian Holdings, Inc.

In addition to providing patient engagement, data analytics, enhanced care coordination, we also provide Independent Medical Review Services utilizing case-specific patient information and industry standard care guidelines, including treatment protocols and current scientific evidence.

Our team of board certified medical professionals in various medical specialities, provides our clients the highest quality evidence based medical reviews, using industry most stringent standards and protocols with respect to quality assurance, HIPAA compliance, PHI confidentiality and data security.

Under the now implemented Patient Protection and Affordable Care Act (PPACA) of 2010, also known as "OBAMACARE", we may be designated as the Independent Review Organization (IRO) by government agencies, payors or contracted entities to review cases concerning an adverse decision. Additional information to help us review the case could be sent in writing via the regular mail, fax or through a designated secure web portal.

For patient clients, you must submit additional materials to help us review your case within 5 business days upon receipt of your mailed "review acceptance" letter. Please include a copy of this letter and mail or fax the information to:

Via Mail:
Meridian Health Systems ACO Corporation
External Review Processing
4477 West 118th Street Suite 304
Hawthorne, California 90250

Via FAX: 310-693-8082

N/B: Materials submitted to us either by mail or fax will not be returned upon completion of review.

Through designated secure web portals shown below, we perform the following types of services:

Payor Portal
Services:--->


Complaint Unit/Coding

Medical consulting

Disability determination

Dental care review

Vision care review

Appeals review

Workers Compensation

Medical imaging review

Utilization review

Quality of care

Plan Interpretation

Emergent/Urgent review

Residual Functional Capacity review

Pharmaceutical review

Adverse decision review

Billing review retrospective

Medical necessity review

Independent medical review

Experimental/Investigational treatment review

Hospital Portal
Services:--->


Coverage Issues

Readmission review

Continued stay review

Utilization review

Quality of care review

Pharmaceutical review

RAC denials & appeals review

Billing and coding

Length of stay review

Clinical compliance review

Revenue cycle management

Patient safety & risk analysis

Medical imaging Review

Cardiology Procedure review

Medical necessity review

Clinical documentation services

Clinical decision support services

Concurrent Medicare & Medicaid Review

MAC,MIC,QIO denials & appeal

Patient Portal
Services:--->


Patient appeals review

Quality of care issues

Coverage issues

Standard of care review

Adverse decision review

Patient relationship management

Experimental/Investigational treatment review

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