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The National Association of Independent Review Organizations (NAIRO) is an industry trade association formed in 2000. NAIRO is comprised of URAC accredited Independent Review Organizations (IROs), Health Utilization Management (HUM), Workers’ Compensation Utilization Management (WCUM) entities, and companies and individuals who support the medical, utilization and peer review industries. NAIRO’s mission is dedicated to protecting the integrity of the medical peer review and utilization review processes. NAIRO has become a recognized industry thought leader by providing accredited organizations and supporting entities with a collaborative and uniform industry voice. NAIRO focuses its primary effort on key industry initiatives, legislation, regulations, accreditation, and other matters that impact all review stakeholders. NAIRO membership offers unique advantages including:

♦ Partner with leading IRO, HUM, and WCUM organizations to shape the development of accreditation standards, including providing collective feedback on URAC's review processes. NAIRO has a long standing collaborative relationship with URAC leadership, including an active seat on the URAC Standards Committee since 2006.

♦ Receive legislative and regulatory updates via a monthly report provided to members. This report provides members with advanced notice on new and changing state and federal medical review and managed care statutes and regulations. NAIRO monitors this critical data using the Lexis Nexis State Net bill tracking service. Please click here for a sample of our State Net Report.

♦ Affords a unique opportunity to build relationships with executives from leading IROs, HUM and WCUM organizations across the country. NAIRO hosts an in-person Educational Symposium Event, periodic virtual webinars, and quarterly membership conference calls.

♦ Assist in modeling state and federal external review processes, regulations affecting internal and external appeals, surprise billing dispute resolution (IDR) legislation and processes, and HUM and WCUM regulations. Provides a powerful platform for members to provide input on regulatory issues to state and federal agencies.

Independent Medical Review

Independent medical peer review services, provided by Independent Review Organizations (IROs), are designed to ultimately reduce payor administrative costs and ensure that patients receive proper treatments. Rising healthcare costs affect millions of people daily, and insurers can rely on IROs to help them to control costs and offer affordable coverage.

Defining IRO

URAC-ACCREDITED IROs

NAIRO is an association of URAC-accredited IROs collaborating on issues facing the rapidly changing healthcare and workers’ compensation arena. NAIRO leadership and its member-driven committees track legislative and regulatory developments at the federal and state level, advances in accreditation standards, and emerging themes such as cybersecurity, trust, compliance, and more.

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