Experience the CPHCR Difference
Christopher Place Healthcare Review (CPHCR) partners with payers, health plans, Managed Care and Coordinated Care Organizations (MCOs/CCOs), Third-Party Administrators (TPAs), and benefit administratorsto deliver independent, evidence-based utilization management and external review services. As an experienced clinical review organization, CPHCR supports fair, unbiased medical-necessity determinations across all medical specialties, aligned with applicable regulatory and accreditation standards.
Our UM and IRO review services include nurse-led utilization review, medical director and specialty-matched physician reviews, pharmacy benefit evaluations, and formal external and appeal reviews. Every determination is grounded in plan-specific medical policy, benefit language, nationally recognized clinical guidelines, FDA labeling, and current standards of care, ensuring decisions are clinically sound, defensible, and audit-ready.
CPHCR helps organizations:
- Control medical and administrative costs by reducing unnecessary services and avoidable appeals
- Streamline utilization management workflows with timely, reliable turnaround
- Meet UM, IRO, and external review compliance requirements with consistent, well-documented determinations
- Build trust with members, providers, and regulators through transparent, independent review
From national insurers to regional and specialty plans, CPHCR delivers scalable utilization management and independent review solutions that support confident decision-making and measurable results.
Independent Review Organization Services
As an independent IRO, CPHCR delivers medical necessity determinations and external reviews that comply with applicable state and federal requirements.
Our reviews are free from payer or provider influence and designed to withstand regulatory and legal scrutiny.
Utilization Management & Medical Necessity Review
CPHCR supports prospective, concurrent, and retrospective utilization management across medical, behavioral health, and pharmacy services.
Our clinical reviewers all have extensive clinical and relevant experience that help reduce unnecessary costs while maintaining clinically appropriate care.
Behavioral Health & Pharmacy Expertise
We maintain national coverage across behavioral health, substance use disorder, and pharmacy review services—ensuring specialty-matched expertise and defensible outcomes.