Independent reviewer

An independent reviewer, often employed by insurance companies or regulatory bodies, serves as a neutral party to assess healthcare disputes. Their role involves reviewing cases where patients and healthcare providers disagree on treatment decisions, coverage determinations, or billing issues. Independent reviewers evaluate medical records, clinical guidelines, and other relevant information to make impartial judgments regarding the appropriateness and necessity of care. Their goal is to ensure fair and equitable resolutions that prioritize patient well-being while adhering to established standards of care and insurance policies. Independent reviewers play a crucial role in facilitating transparency, accountability, and trust within the healthcare system by providing unbiased assessments of contentious issues.