How Clinician Credentialing Best Practices Help Leading Accredited IROs Ensure Independent Medical Review

April 15, 2019 – One of the pillars of protecting the integrity of the review process for all stakeholders within the healthcare industry is to conduct secure and prudent clinician credentialing. This is a critical process within the realm of independent review organizations (IRO) and utilization management (UM) organizations. Vetting and contracting with qualified clinicians…

IROs Bring Evidence-Based Standards to Experimental/Investigational Medical Reviews

In the constantly evolving world of medical research and development, cutting-edge treatments start out in a clinical trial setting and, if proven safe and effective, will become acceptable in the day-to-day practice settings of health care providers. Some advanced cancer treatments and biological therapies are just two examples of treatment methods that will pass through…

NAIRO | Common Challenges during Medical Review

Common Challenges Confront Review Organizations During External Medical Review

Many times in the demanding field of external medical review, the art and science of producing a high-quality report comes with its own set of unique challenges and obstructions. Independent review organizations (IROs), which provide non-biased reviews of medical coverage and other decisions, often face rapid deadlines, incomplete medical records and what can be a…