Clear communication is essential in many facets of life. Whether it’s a teacher telling students about classroom rules or a physician explaining a diagnosis to a patient, providing easy-to-understand direction is important. This need for clear and open communication is evident in the healthcare industry because it can make the difference in outcomes, patient safety, […]
In a study conducted by The Journal of Healthcare Information Management, it was discovered that 86 percent of mistakes made in the healthcare industry are administrative. These small administrative mistakes, whether it’s the misspelling of a name or a misrecorded number, can have a major effect when they go unnoticed. With the fast-paced and, at […]
The healthcare industry continues to be one of the fastest growing industries in the United States and is the largest source of jobs in the country. That’s not surprising as U.S. healthcare spending is approximately $3.3 trillion or $10,348 per person annually. According to the Peterson-Kaiser Health System Tracker, relative to the size of its […]
For years, the number of practicing physicians in the U.S. has not maintained pace with the rising demand for medical services. This trend has created a physician shortage, with consequences extending far beyond the doctor’s office to essential workflows throughout the American healthcare system, including the medical review process. The Association of American Medical Colleges […]
Now that suitable supporting infrastructure is more readily available, VR is rapidly taking root in healthcare.
Wondering where an IRO fits into the external review process? How about whether an RN versus an MD can approve or deny a case? Check out our infographic on The Life of a Group Health Case to learn about physician-level reviews and the role of an IRO in Group Health plans!
How Has the Affordable Care Act Affected IROs? A crucial consumer protection in the Affordable Care Act — the right to appeal to an outside entity when an insurance company denies payment – received relatively little public attention -but it’s creating noteworthy opportunities and challenges for independent review organizations (IROs). The Affordable Care Act (ACA) carves […]