Medical External Review Organizations

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Home [www.nairo.org]

https://www.nairo.org/

The National Association of Independent Review Organizations (NAIRO) is dedicated to protecting the integrity of the independent medical peer review processes. Drawing on the expertise of thousands of board-certified clinicians throughout the country, NAIRO and its …

Independent Utilization Review and Clinical …

https://www.mrioa.com/

Medical Review Institute of America (MRIoA) delivers technology-enabled review services that increase member satisfaction, decrease the costs of overutilization, …

HHS-Administered Federal External Review Process for …

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Consumer-Support-and-Information/csg-ext-appeals-facts

The HHS-Administered Federal External Review Process applies to “adverse benefit determinations,” including those that involve medical judgment (including, but not …

External Review | HealthCare.gov

https://www.healthcare.gov/appeal-insurance-company-decision/external-review/

Independent Review Organization Accreditation - URAC

https://www.urac.org/accreditation-cert/independent-review-organization-accreditation/

URAC is proud to work with the National Association for Independent Review Organizations (NAIRO) to track related legislation and regulatory standards, advance accreditation …

Independent Review Organization Services - National Medical …

https://nationalmedicalreviews.com/independent-review-organization/

NMR has full accreditation from URAC as an Independent Review Organization – Comprehensive Review (both Internal & External). NMR is able to provide Independent …

Independent Medical Reviews - National …

https://nationalmedicalreviews.com/

Account Management – Every client is assigned a primary Review Coordinator, a licensed nursing professional. Review Coordinators – These nurses provide clinically-based …

External Appeals | CMS

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Consumer-Support-and-Information/External-Appeals

State and Federal External Review Process Under new Affordable Care Act rules, plans and issuers must comply with the state’s external review process or the …

Independent Review Organizations (IRO) - Texas …

https://www.tdi.texas.gov/hmo/mcqa/indexiro.html

An IRO determines the medical necessity and appropriateness of health care delivered or proposed to be delivered by a health care provider. An IRO is responsible for …

Medicaid External Quality Review - HSAG

https://www.hsag.com/en/medicaid-external-quality-review/

Medicaid External Quality Review Medicaid External Quality Review Health Services Advisory Group (HSAG) is the largest External Quality Review Organization …

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