MCMC

Healthcare utilization management and review services, namely, the planning, coordination, monitoring, and evaluation of medical services with an emphasis on quality of care, continuity of services, and cost-effectiveness; independent health care cost review; medical bill review; submission of medical bills to healthcare provider networks in attempt to secure client savings that may result from discounted fees for services rendered by the provider pursuant to contractually determined rates, conducted electronically and over the telephone, and related administrative services; medical bill review and repricing technology services, namely, intelligent cost containment and pre-certification services; retrospective review of medical claims record to determine necessary and appropriate payments; review of quality of care at hospitals, healthcare providers and pharmacies; pharmaceutical, forensic and experimental and investigational treatment reviews; development of claims standards and criteria for healthcare management systems, plans, and programs

Multi-level appellate reviews of ERISA administration appellate decisions; alternative dispute resolution, namely, resolution of disputes regarding healthcare decisions or plan administration