Independent Medical Review Experts You Can Trust
Delivering unbiased, high-quality external medical reviews to ensure fairness and compliance.
External Medical Reviews
Join Our Physician Panel
Regulatory Compliance
We operate with transparency, confidentiality, and full regulatory compliance.
About Us
Delivering Fair, Evidence-Based Medical Reviews
Pinnacle Review Group LLC is an Independent Review Organization (IRO) dedicated to providing unbiased and evidence-based external medical reviews.
We work with health plans, providers, and patients to ensure fair, compliant, and transparent medical determinations when coverage decisions are appealed.
100%
HIPAA-Compliant Reviews
Our Core Service
External Medical Reviews
When a healthcare service is denied twice by an insurance company, the case may be referred to an independent third-party for review.
That’s where Pinnacle Review Group comes in.
Our board-certified physician reviewers evaluate each case objectively, using medical evidence and compliance guidelines to determine whether the denial should be upheld or overturned.
How Our Process Works
Case Submission
The case is referred to us by a health plan or regulatory agency.
Reviewer Assignment
A qualified, board-certified physician is selected based on specialty.
Case Review
All medical records and supporting documents are carefully analyzed.
Final Decision
A comprehensive review report is issued, either upholding or overturning the decision.
Join Our Physician Network
We partner with experienced, board-certified physicians across multiple specialties to deliver accurate and timely reviews.
If you’re a physician interested in joining our panel, we welcome your expertise