By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    benefits of using protein powder to build muscles
    Protein Powder for Muscle Mass: Everything You Need to Know
    December 12, 2021
    changes brought on by blockchain in healthcare
    Technology In The Healthcare Industry
    March 28, 2022
    What Does Core Body Temperature Say About Health?
    August 17, 2022
    Latest News
    Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
    May 16, 2025
    Learn how to Renew your Medical Card in West Virginia
    May 16, 2025
    Choosing the Right Supplement Manufacturer for Your Brand
    May 1, 2025
    Engineering Temporary Hospitals for Extreme Weather
    April 24, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    FDA Approves Diabetes Pill
    May 2, 2011
    Patient Gets Drunk on Hand Sanitizer
    June 20, 2011
    Cultivating Health Improvement
    July 20, 2011
    Latest News
    Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
    May 18, 2025
    The Critical Role of Healthcare in Personal Injury Recovery: A Comprehensive Guide for Victims
    May 14, 2025
    The Backbone of Successful Trials: Clinical Data Management
    April 28, 2025
    Advancing Your Healthcare Career through Education and Specialization
    April 16, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: A Commitment to Quality IRO Services – A Letter From Our Medical Director
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > A Commitment to Quality IRO Services – A Letter From Our Medical Director
Business

A Commitment to Quality IRO Services – A Letter From Our Medical Director

DanyellJones
Last updated: September 16, 2015 12:00 pm
DanyellJones
Share
5 Min Read
IRO Services
SHARE

A Commitment to Quality IRO Services – A Letter From Our Medical Director

IRO Services

Contents
A Commitment to Quality IRO Services – A Letter From Our Medical DirectorA Commitment to Quality IRO Services – A Letter From Our Medical Director

Hello,

My name is Dr. Kevin Roache, and I am the Medical Direcor of IRO Services at BHM Healthcare Solutions.

A Commitment to Quality IRO Services – A Letter From Our Medical Director

IRO Services

More Read

New Ways to Engage with Patients
Unbundling the Bundled Payment Program
OB-GYN vs. Cosmetic-Gyn
Why the TD2 DEEP 6 AI Partnership Is Good for Your Hospital
Top 10 Healthcare Takeaways from #SXSW2014: Part One

Hello,

My name is Dr. Kevin Roache, and I am the Medical Direcor of IRO Services at BHM Healthcare Solutions.

BHM Healthcare Solutions’ mission is, “to provide clients with expert guidance that results in an improved financial and operational efficiency demonstrated through enhanced clinical care, compliance and profitability with better-quality outcomes.”  

The Quality Management Program (QMP) is the vehicle through which BHM Healthcare Solutions, Inc. analyzes data collected by operational staff from the electronic Peer Review System (PRS) or through manual tracking.  Such data analysis involves continual systematic measurement, monitoring, evaluating, and implementing changes in operations to improve performance of our IRO Services. The Quality Management Program (QMP) objective is to promote fulfillment of the BHM mission in relation to IRO Services.

The scope of the QMP is ever-changing in order to maintain the spirit of continuous quality improvement.  Techniques for monitoring, evaluating, and improving services offered by the Independent Review Organization(IRO)/External Review Organization (ERO) program are in a constant state of adjustment, fine-tuning, and testing. This allows for continually improving IRO Services.

BHM’s commitment to high-quality IRO Services is dependent on recruiting experienced, board-certified physician reviewers, maintaining rigorous credentialing standards for these physicians, providing them with appropriate education on the IRO/ERO program, ensuring compliance with Policies and Procedures and evaluating the quality of reviews by auditing the reviews provided by these clinicians. Additionally, Physician Reviewers are provided ongoing mentoring and counseling opportunities from senior BHM Medical Directors.

BHMs IRO/ERO Department is staffed by highly-qualified individuals who provide support for physician reviewers, internal and external stakeholders and clients. The IRO/ERO Division has extensive experience in Behavioral Health reviews, Clinical reviews and is planning to expand its services to Medicare Advantage Part D reviews. The Peer Review System (PRS) is a BHM proprietary software program that allows for consistent, rapid, turnaround times for client requests, outcomes tracking, client customization and auditing capabilities to ensure that BHM maintains the highest quality standards.  The Program has consistently received high client satisfaction ratings.

BHM Healthcare Solutions (BHM) conducts reviews ensuring the process is independent of all affected parties. BHM reviews cases upon request from the referring entity to determine if a healthcare service is medically necessary or experimental, or to address administrative issues. BHM utilizes a network of board-certified physicians and other peer healthcare professionals with diverse specialties, who have appropriate experience and expertise to render a decision for each independent review request.

BHM has achieved ongoing URAC accreditation to ensure that the QMP and the IRO Services Program meet the standards of quality and excellence for that accrediting body. In August 2015 BHM received a three year Certificate of Full Accreditation from URAC for compliance with Independent Review Organization: Comprehensive Review (Internal & External) Accreditation Program. The URAC accreditation is a testament to BHM’s commitment to quality.

It is the goal of the BHM Healthcare Solutions, (BHM) to manage and ensure that services provided are appropriate and timely. The management of these services requires BHM to provide the oversight, auditing, and monitoring necessary to ensure compliance with BHM’s client contracts and with applicable local, state, and federal laws and regulations. The Regulatory Compliance Program is developed to provide guidance to all appropriate parties in fulfilling its contractual requirements and in following all regulatory requirements. The Compliance Program ensures that state license or certifications are obtained as required by state law. The Regulatory Compliance Program demonstrates BHM’s commitment to legal and ethical behavior and to effectively communicate the expected code of conduct to all responsible parties.

To learn more about BHM IRO Services, or to schedule a demo of our system email us at results@bhmpc.com or simply click below.

Contact-us-button

Best Regards,

Kevin Roache, MD, MMM

Medical Director IRO Division

The post A Commitment to Quality IRO Services – A Letter From Our Medical Director appeared first on BHM Healthcare Solutions.

Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Do You Grind Your Teeth at Night? Here’s How Night Guards and TMJ Treatments Can Help
Do You Grind Your Teeth at Night? Here’s How Night Guards and TMJ Treatments Can Help
Dental health
May 21, 2025
The Secret To A Confident Smile: Top Tips For Better Teeth
The Secret To A Confident Smile: Top Tips For Better Teeth
Dental health
May 21, 2025
Clinical Expertise
Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
Health care
May 18, 2025
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Health
May 15, 2025

You Might also Like

A Culture of Safety in Hospitals and the CEO’s Role

October 31, 2011

Workplace Wellness Meets in the Middle of the Aisle

June 14, 2011
dollarshc
BusinessFinanceHospital AdministrationPolicy & LawPublic Health

Sky-High Hospital Prices: A Result of Government Interference

December 17, 2013

Is Medicaid Cheaper and Better than Private Insurance?

January 27, 2012
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?