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
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Eliminating Risk with Independent Review Organizations & External Reviews
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 > Finance > Eliminating Risk with Independent Review Organizations & External Reviews
BusinessFinanceGlobal HealthcareHealth ReformHospital AdministrationMedical EthicsMedical RecordsPolicy & LawTechnology

Eliminating Risk with Independent Review Organizations & External Reviews

Moira O'Connell
Moira O'Connell
Share
4 Min Read
mitigating-risk-II-e1383041558507
SHARE

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.

Contents
  • 2. Uncovering Internal Issues
  • 3. Reduce Conflicts of Interest
  • 4. Increase Quality
  • Do you want to know more about mitigating risk through IROs? Click on the image below for our free white paper!

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.

 

1. Improving Documentation

Having an external reviewer, who is often a peer, can help ensure physicians pay closer attention to detail and documentation. Attention to detail and accuracy are key to reducing error and the possibility that an external review will be needed. By helping encourage double-checking and accuracy, IROs help reduce risk on the back-end, which in turn effects your ROI.

More Read

Waiting for HIPAA Clarity? Who Has Time?
America’s Aging Eyes
First Treatments Completed for Parkinson’s Disease Study Sponsored by the Focused Ultrasound Foundation
OXiGENE Releases Promising Phase Two Data For Lung Cancer Drug
A Vision For Health Care In America

2. Uncovering Internal Issues

External reviews help you discover issues that might lie within your organizational structure, whether that is physician specific, event specific or even organization based. Deeper issues can be brought the surface because of external reviews. By bringing these issues to the surface external reviews help address these problems in a timely manner. Uncovering and addressing organizational issues is a key way IROs help to reduce risk and the potential of malpractice or litigation.

3. Reduce Conflicts of Interest

The certification of External reviewers and the review process help to ensure that there are no conflicts of interest between reviewers or at the organization level. When it comes to specific cases/reviews, an organization is required to certify that there are no conflicts of interest at the organization level. The same is required of the reviewer. This helps reduce any risk that there might be a conflict of interest that could negatively impact a review.

4. Increase Quality

IROs help improve member satisfaction through provision of an unbiased, evidenced-based external determination. IROs have a standard set criteria that guide decision-making and use the latest technology, helping to increase the quality of care your organization provides. Since reviews are based purely on the fact that they provide unbiased decision, your staff can rest assured that their decision-making abilities won’t be questioned. By freeing up medical directors and other administrators, external reviews ensure that executive staff can spend less time with the administrative burden and deal with larger tasks as needed.

Do you want to know more about mitigating risk through IROs? Click on the image below for our free white paper!

mitigating-risk-II-e1383041558507

Find the original blog post here.

Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Epidemiological Health Benefits
Personal and Epidemiological Health Benefits of Blood Pressure Management
Health
October 13, 2025
Traumatic Brain Injuries
Understanding Traumatic Brain Injuries: What Families Need to Know
Policy & Law
October 10, 2025
Remote Monitoring touchpoints
Remote Monitoring Touchpoints Patients Will Actually Follow
Technology
October 9, 2025
dental care
Importance of Good Dental Care for Health and Confidence
Dental health Specialties
October 2, 2025

You Might also Like

doctors and social media
BusinessSocial Media

The Compelling Case for Doctors to Warmly Embrace Social Media

November 23, 2014

Bullying and Social Hierarchies in Schools

March 15, 2011
healthcare technology
BusinesseHealthFinanceHealth ReformMobile HealthPolicy & LawTechnology

Technology May Make Capitation in Healthcare Work

July 31, 2013

Survey: Public Opinion on ACA Ahead of SCOTUS Ruling

February 2, 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?