Glossary of review firm terms
Short version: 16 terms you will meet on review firm websites and in their contracts, each in 1 or 2 plain sentences, with the page on this site where the term matters.
Limits: Firm facts come from each firm's own website, read 2026-11-12; we haven't hired these firms or graded their reports, and "not stated" means we didn't find it, not that the firm doesn't do it.
Peer review terms
- External peer review
- A review of a physician's care or conduct by a reviewer from outside the hospital's medical staff, usually through a firm. Used when no internal peer can review without a conflict, or when the stakes are high. See hospital peer review firms.
- FPPE (focused professional practice evaluation)
- A time-limited evaluation of a practitioner, used for new privileges or when a concern about performance comes up.
- OPPE (ongoing professional practice evaluation)
- A recurring evaluation of every privileged practitioner against indicators the medical staff sets. Some firms help design the OPPE form as well as score cases.
- MEC (medical executive committee)
- The medical staff committee that usually decides whether a case goes to external review and acts on the result.
- Fair hearing
- The hearing a physician can request after an adverse privileging action. Hospitals sometimes need an outside expert for it.
- Conflict attestation
- A written statement, per case, that the reviewer has no financial, competitive or personal tie to the physician or the hospital. Only 2 of 39 firms we list say they collect one per case or state their reviews are free of conflict.
Utilization review terms
- Utilization review
- Review of whether care is or was medically necessary, under a plan's criteria: before (prior authorization), during (concurrent) or after (retrospective).
- IRO (independent review organization)
- An organization that decides appeals of coverage denials outside the plan's own staff, often under state or federal external review rules. Many hold URAC accreditation.
- URAC
- A nonprofit that accredits health care organizations, including IROs and utilization management programs. Accreditation is voluntary and, per AMR's summary, renewed every 3 years.
- Peer-to-peer
- A call between the reviewing physician and the treating physician before or after a determination. MES says most of its peer reviews require that contact.
- Physician advisor
- A physician who reviews cases for medical necessity or level of care, often for a hospital's UR program or for a payer. Some UR firms supply physician advisors on demand.
Reviewer credential terms
- ABMS
- The American Board of Medical Specialties, whose 24 member boards certify MD and DO specialists. National Medical Reviews says its panel covers all 24.
- AOA board certification
- Certification by the American Osteopathic Association's specialty boards. MES and National Medical Reviews accept it alongside ABMS.
- Specialty match
- Assigning a reviewer who shares the specialty, and ideally the practice setting, of the physician or service under review. See firms by specialty.
- Primary source verification
- Checking a reviewer's license, board status and training directly with the issuing body rather than trusting a copy. MLS states it.
- LNC (legal nurse consultant)
- A registered nurse who reviews records for legal cases. Several prep firms and MRN use LNCs to run cases or write reports.
Questions about these terms
What is the difference between FPPE and OPPE?
FPPE is a time-limited evaluation triggered by new privileges or a concern. OPPE is the recurring evaluation of every privileged practitioner. External firms can help with both.
Is an IRO the same as a peer review firm?
No. An IRO decides coverage appeals for health plans; a hospital peer review firm evaluates a physician's care for the medical staff. Some firms, such as CIMRO, do both.