Reviewer credentials: what each review firm states

By Ahmed Jemaa, Co-Founder and CEO of Medrecords AI. Updated 2026-11-14.

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.

The 5 credential checks, firm by firm

"Stated" means the firm's own pages say it, in words we could quote. "Not found" means we read the firm's main service pages on 2026-11-12 and didn't see it. Firms with more stated checks are listed first.

What each check means and why it matters

Board certification

Certification by an ABMS member board or the AOA. MLS requires ABMS certification for its panel. MES accepts ABMS or AOA. For hospital peer review, medical staff bylaws often require a reviewer certified in the same specialty as the physician under review.

Active practice

The reviewer still treats patients. MLS says URAC guidelines require active practice outside IME and review work. MES asks for at least 5 years of direct patient care, which is experience, not current practice. Enlyte accepts active practice or active medical teaching. A reviewer who stopped practicing years ago will be challenged on whether they know the current standard.

Specialty match

The reviewer shares the specialty, and ideally the practice setting, of the physician or the service under review. See firms by specialty for how each firm defines it.

State license match

The reviewer holds a license in the state of the provider or the plan. MLS and National Medical Reviews state it, NMR "when required." It matters in utilization review and appeals under state rules; for hospital peer review it is usually a preference, not a rule.

Conflict check

A written statement, per case, that the reviewer has no financial, competitive or personal tie to the physician or the hospital. Quality Peer Solutions states a per-case attestation; MET says its reviews are free from conflict. Most firms don't say how they check.

How firms vet reviewers before the first case

A few firms describe the vetting itself, which tells you more than a list of credentials.

Nurse and clinician reviewers in prep firms

Case prep firms mostly use nurses. Magna says its nurse reviewers hold LNC credentials; MLCS and BMC Group describe legal nurse consultants; NaviCase uses NPs, PAs and physicians in active practice. For a physician buying prep, the question is narrower than for peer review: who wrote the summary, what license they hold, and whether a clinician checked it against the record. The case prep page compares the 15 prep firms.

Credential checklist for your shortlist

Work through this on a call with each firm, and tick only what the firm confirms in writing for your case. The score is a prompt for follow-up questions, not a grade of the firm.

The 3 items worth 2 points are the ones a reviewed physician challenges first. Copy the list into your own vendor file if you prefer paper.

Questions about reviewer credentials