Why Outsource to an Independent Review Organization (IRO)?
Many payers and medical management companies have not discovered the power of outsourcing their medical decision making to an independent review organization…often because they’ve already assembled their own panel of internal doctors or using their own medical staff to make such decisions. Yet with rising state and federal regulations regarding the need for objective, unbiased decision based purely on medical fact, independent review organizations (IROs) offer a simple, easy alternative to other forms of medical decision making, including pre-authorizations that are critical for delivering high quality care according to patient needs. IROs play an important role in providing care in America’s health care system today. Over the last couple of decades, they evolved as a result of the patient rights movement. Patients increasingly demanded a fair hearing and a fair decision about whether or not they would be approved medical treatments. IROs filled that need. IROs began working by adjud
