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!
Tag: external appeals
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 […]