Eliminating Risk with Independent Review Organizations

We’ve been talking a lot lately about how and where Independent Review Organizations, or IROs, fit into denial management. The Peer Review process, which brings in an unbiased third party to help alleviate the pressure of reviewing claims, is an essential part of denial management. We’ve touched on many of the different benefits of IROs in previous blog posts, from how they affect your ROI to how they bring specialized expertise to reviews. This blog post focuses on the four main ways IROs and external reviews can help eliminate risk within your organization.

Is IRO Right for You?

You often hear the terms “peer review”, “independent medical review”, “hospital peer review” and “medical peer review” thrown around and you might be wondering what the difference between them is. Well, there isn’t one! The term “peer review” is the simplest way to encompass what all of those terms are trying to say, and it’s becoming the industry standard.

Peer Review Demystified

Peer review and quality. Healthcare is an industry that perhaps has even surpassed car manufacturing in concern with quality measures. And it should be. After all, we’re dealing with human beings, not cars. Peer review often concerns itself with peering closely at quality measures, compliance and safety. Patients are already vulnerable when they enter the hospital, due to illness or injury, so it is everyone’s concern in healthcare to be mindful of what areas of weakness within an organization could be influencing patient outcomes in a negative way.

Physician Peer Review Technology: The BHM Difference

Are you in the market for a Peer Review system that offers a simple and effective solution, full report functionality, PPACA Healthcare Reform and HIPAA compliant with URAC accreditation? BHM Healthcare’s proprietary PRS Portal integrates fully with the modern healthcare system, making it your one-stop-shop for independent review.

You Might Need an Independent Review Organization if…

Summary: An Independent Review Organization is designed to provide unbiased peer reviews in a manner that complies with all federal and state regulations, including those set forth by URAC Accreditation and the Affordable Care Act. We have all heard Jeff Foxworthy’s “You Might Be a Redneck if….” Some of his catch phrases include:

Pin It on Pinterest