The Value of a URAC Accredited IRO

August 27, 2015
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URAC Accredited IRO

The Value of a URAC Accredited IRO – Independent Review Organization

Not all Independent Review Organizations are created the same. Some look to go beyond the standard provision of reviews, and strive to achieve a quality designation in the Independent Review Industry – URAC Accreditation.

URAC Accredited IRO

The Value of a URAC Accredited IRO – Independent Review Organization

Not all Independent Review Organizations are created the same. Some look to go beyond the standard provision of reviews, and strive to achieve a quality designation in the Independent Review Industry – URAC Accreditation. In today’s post we will talk about why making sure your Independent Review Organization, or IRO, is accredited makes a difference, what that difference is, and how that translates to higher quality services for your patients. Let’s jump in!

What Is a URAC Accredited IRO – Independent Review Organization?

A URAC Accredited Independent Review Organization is an organization who has been vetted by URAC, a third party non-profit accrediting body. According to the URAC website, the organization

“Is well-known as a leader in promoting health care quality through its accreditation and certification programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC strives to ensure that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry”

How can you tell if your IRO is a URAC Accredited IRO?

There are a few ways that you can tell if your IRO has achieved the quality designation of being a URAC Accredited Independent Review Organization.

  1.  You can look up the organization on the URAC Website which provides a directory of accredited organizations (Independent Review Organizations, as well as other accredited organizations) via this quick link: access the database here 
  2. You can refer to the helpful National Association of Independent Review Organizations (NAIRO) website here, which provides a list of URAC Accredited Independent Review Organizations
  3. You can check the organizations website for the official URAC Seal, which every accredited organization is asked to display with a link back to the company listing on the URAC Website. For instance here is a copy of the BHM Healthcare Solutions URAC Seal:

Seal_IRO_Comprehensive_cert

How does being a URAC Accredited IRO translate to the better provision of Independent Review Services?

Before achieving Accreditation, an Independent review organization must meet a number of quality standards, some of the most critical standards pertain to the following:

  • Ensuring that those performing reviews are free from conflicts of interest
  • Ensuring reviewers are appropriately credentialed and trained
  • Ensure timeliness standards are met for the completion of medical reviews
  • Address medical necessity and experimental treatment issues
  • Ensuring that the organization has a sound structure with strong policies and procedures in place
  • Works to ensure that organizations are looking to continuously improve quality, monitor complaints and customer satisfaction ratings, and work on elevating overall delivery of services

How does this all translate to a higher standard of care for your patients and consumers?

By selecting a URAC Accredited IRO for the provision of Independent Review Services for your organization, you are in effect guaranteeing that the services provided will meet an industry described and selected standard of quality. This means that you do not have to worry about the quality of the reviews performed, or any conflict of interest when it comes to reviews for your patients. It also means the URAC Accredited Independent Review Organization will hold itself to certain standards related to the timeliness of reviews, validity of organizational structure, and continuous quality monitoring.

By selecting a URAC Accredited Independent Review Organization you are by proxy ensuring a higher level of services for your patients and consumers when it comes to the review process.

“By receiving URAC accreditation, the company has demonstrated a commitment to quality healthcare,” states URAC President and CEO Kylanne Green. “Quality healthcare is crucial to our nation’s welfare and it is important to have organizations that are willing to measure themselves against national standards and undergo rigorous evaluation by an independent accrediting body”

To learn more about BHMs URAC Accredited IRO services, or to schedule a demo of our Independent Review platform click below

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