5 Tips for Medical Directors

Whatever the title, Medical Director, CMO, or similar, the responsibilities loom large with little relief in sight. Burnout, recruitment, and retention might be a larger concern than medical necessity criteria, case shaping, and utilization management. The end of the ACA won't likely make things easier. With that in mind, here are 5 time-saving tips for medical directors.

5 Tips for Choosing a Peer Review Program

Choosing the right Peer Review Program can be difficult. It’s important to look for a Peer Review Program that distinguishes itself through quality work, ongoing training, full compliance, and the latest technology. You want to trust the organization you choose and make sure they are industry certified. Use these 5 tips to help you choose a Peer Review Program or use as a guide for your current vendor.

Does your review process protect against conflicts of interest?

Peer-to-Peer and Physician Advisory Review Programs are a crucial part of driving quality improvement throughout healthcare organizations. They are key to helping organizations maintain credibility and support effective unbiased reviews. Thanks to the Affordable Care Act, consumers expect unbiased review of their care through the claims and appeals processes. Independent Review Organization have now been placed in the forefront of the healthcare industry.

3 Ways An Independent Review Organization Can Save You Money

The role of the Independent Review Organization (IRO) in the appeals process is to provide an unbiased 3rd party opinion on complicated reviews, helping to assure that all reviews are given the time and care they deserve. It’s a common illusions in the healthcare industry that taking care of things in house is the best and easiest way to save money—however this isn’t true when it comes to claim reviews. If you are trying to manage your denials in-house, it can actually be counterproductive if you’re trying to save money and even time. Let’s take a look at how outsourcing your IROs can save you time and money.

2017-04-02T13:28:07+00:00 By |Uncategorized|

Lunch & Learn: Join us for Workers Compensation: Keeping Claims on Track – a free webinar!

Would you like to learn how Workers' Compensation Organizations and Departments like yours are creating cost savings, improving efficiency, and decreasing claim costs? Join us Wednesday, April 13 at 12:00 PM EDT for a free lunch and learn event titled: Workers Compensation - Keeping Claims on Track. If you can’t make the event, don’t worry! Simply register for the web event to receive a recording of the event as well as a copy of the presentation after it is finished.

Did You Miss Our Free WebClinic Components of a Great Peer Review Program? We’re Relaunching it!

Join BHM experts Tuesday, December 15 at 12:00 PM CST for the complimentary webinar “Components of a Great Peer Review Program.” This not-to-miss exclusive event will reveal essential components that organizations need to create a Peer Review program that provides added and ongoing value to healthcare organizations.

3 Ways Independent Review Organizations Help Save You Money

We’ve been talking a lot lately about Independent Review Organizations and the appeals process that accompanies them. The role of the IRO in the appeals process is to provide an unbiased 3rd party opinion on complicated reviews, helping to assure that all reviews are given the time and care they deserve. It’s a common illusions in the healthcare industry that taking care of things in house is the best and easiest way to save money—however this isn’t true when it comes to claim reviews. If you are trying to manage your denials in-house, it can actually be counterproductive if you’re trying to save money and even time. Let’s take a look at how outsourcing your IROs can save you time and money.

Outsourcing Your IRO: 3 Benefits of External IROs

There are times when we all can benefit from an outside perspective, in both life and in work. For healthcare, this outside perspective comes in the form of external Independent Review Organizations (IRO). An external IRO not only give perspective that differs from “insider” knowledge, but it’s also views situations in an entirely new light with set a quality set of standards and procedures. In some cases an external IRO may be required, but if not they are still a highly beneficial option. External IROs offer a unique perspective that is not only beneficial, but entirely necessary. Here are 3 reasons why outsourcing your IRO is a good idea.

5 Key Elements of the Peer Review Process

Lately we have been talking about the important of Independent Review Organizations (IROs) and peer reviews in the healthcare ecosystem. Today we continue this discussion and delve deep into the importance of the peer review process. We know that peer reviews are a crucial part of healthcare because they hold medical professionals and organizations accountable in addition helping to build a world of trust between patient and physician. The peer review process is one that consists of high levels of property technology and superior customer service. By boosting transparency in healthcare, peer reviews have become an essential standard helping to make healthcare safer and more efficient. So let’s take a look at the 5 core building blocks of the peer review process.

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