More Americans are turning to technology first to evaluate health conditions, and a growing number are interested in using the internet to access medical care, while opportunities remain to improve peoples’ understanding of basic health insurance terms and the connection between lifestyle choices and disease, according to a new study. UnitedHealthcare shares results in a new report.
Healthcare spending is on the rise. The federal government has begun several initiatives to control costs, increase efficiency, and increase quality. Revisiting one of the ACA, Medical Loss Ratio.
Across the country more and more workers compensation organizations are utilizing Workers Compensation Independent Medical Reviews to keep claims on track, and to decrease unnecessary expenditures as they relate to legal proceedings. When choosing an independent medical review network ask if they offer delegation for workers compensation medical reviews. Delegation provides an opportunity for significantly lower administration expenses wile increasing the quality of reviews.
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.
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.
Workers Compensation Independent Medical ReviewsAcross the country more and more workers compensation organizations are utilizing Workers […]
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.
Many case managers look to Independent Review Organizations (IROs) to get help with decision-making and for outside perspective from a trusted source. For some, their collaboration is required. So how do you know when it’s time to start working with an IRO? Here are 10 instances which can help you better identify when its time to look for a partner.
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.