Navigation Links
Independent Review Organizations Take Pressure Off Healthcare Payers as Recession Deepens
Date:2/26/2009

IROs Help Ease Staff Burden, Maintain Compliance and Make Patient Safety a Priority

PORTLAND, Ore., Feb. 26 /PRNewswire/ -- The deepening U.S. economic recession has healthcare payers caught between member demands for better coverage and the need to reduce costs, while they also wrestle with business restructuring, declining budgets and staff cuts. Amid this, the expense and complexity of new technologies, treatments and drugs continues to rise.

"During this recession, payer organizations are servicing claims with fewer personnel, while new treatments and drugs continue to add complexity to them," said Andrew Rowe, CEO at AllMed Healthcare Management (www.allmedmd.com), a leading independent review organization (IRO). "Even with fewer in-house staff, payers can still offer high quality care, by outsourcing their more complex and critical claims and appeals decisions to an IRO," he explained.

Payer appeals departments often use IROs for evaluating the medical necessity of denied claims. These reviews meet ERISA and Department of Labor federal regulations, as well as most state requirements calling for an independent evaluation by a specialist who was not involved in the original coverage determination. "Although compliance is important to payers, forward-thinking health plans also use IROs to improve transparency and objectivity, which boosts their members' and groups' confidence," Rowe said.

Because they staff medical peer review specialists who objectively review healthcare claims for medical necessity, IROs help payers make determinations on their most complex and critical claims. "This ensures patients get the coverage they deserve, while eliminating unneeded treatments and costs," Rowe said. Organ transplants, oncology treatments, growth hormone therapy and bariatric surgery are a few examples of the types of cases IROs evaluate every d
'/>"/>

SOURCE AllMed Healthcare Management
Copyright©2009 PR Newswire.
All rights reserved

Page: 1 2 3

Related medicine news :

1. Sysmex Customer Satisfaction Ranks Highest in Independent Market Research
2. Privacy Watchdog Condemns Google for Effort to Defund it: Calls for Greater Corporate Disclosure About Lobbying Efforts and Independent Privacy Chief
3. WellPoint Joins New York Attorney General in Creation of New Independent Database for Out-of-Network Reimbursement
4. Innophos Holdings, Inc. Elects John M. Steitz as New Independent Director
5. NHP Names New Chairman and Lead Independent Director
6. Former Assistant Secretary for Aging, The Honorable Josefina G. Carbonell, Appointed Senior Vice President at Independent Living Systems
7. Alaska Governor Sarah Palin Is Independent Group Home Living Foundations Honoree of the Year 09
8. Sleep disordered breathing and obesity: Independent effects, causes
9. HPS Establishes Independent Website for its Patent-Pending Mood-Enhancing Compound Naturally Found in Sea Coral
10. Renhuang Pharmaceuticals, Inc. Engages New Independent Auditor
11. Independent Audit of Global Child Immunizations Urged
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:1/22/2015)... 2015 The federal court overseeing thousands of ... Court, Southern District of West Virginia has upheld a $2 ... first bellwether trial. In an Order dated January 21st, the ... finding that C.R. Bard had not proven a miscarriage of ...
(Date:1/22/2015)... January 22, 2015 Thousand of GranuFlo ... Care recalled its GranuFlo and NaturaLyte dialysis concentrates continue ... in U.S. District Court, District of Massachusetts, Bernstein Liebhard ... the Court has remanded a case filed by the ...
(Date:1/22/2015)... 2015 Carinsurancesavings.biz has released a new blog ... dismemberment insurance . , Purchasing an accidental death and ... advantageous. This type of rider provides benefits if the insured ... considered a lesser form of life insurance. , AD&D ...
(Date:1/22/2015)... (PRWEB) January 22, 2015 Yesterday, ... Bonilla (D-Concord) and Kristin Olsen (R-Modesto) were honored ... leadership in advancing biotechnology, biomedical science, medical device ... Olsen each received the “2014 Life Sciences Champion” ...
(Date:1/22/2015)... 2015 Four years since the release of their ... with the marriage of Avasa & Matthew Love – the duo ... scheduled for release through White Swan Records on February 24, 2015. ... a sacred path available to all of us to walk out ...
Breaking Medicine News(10 mins):Health News:Court Upholds $2 Million Vaginal Mesh Lawsuit Verdict Levied Against C.R. Bard in First Federal Bellwether Trial, Bernstein Liebhard LLP Reports 2Health News:Court Upholds $2 Million Vaginal Mesh Lawsuit Verdict Levied Against C.R. Bard in First Federal Bellwether Trial, Bernstein Liebhard LLP Reports 3Health News:Court Upholds $2 Million Vaginal Mesh Lawsuit Verdict Levied Against C.R. Bard in First Federal Bellwether Trial, Bernstein Liebhard LLP Reports 4Health News:Court Overseeing Federal GranuFlo Lawsuits Remands Louisiana Claim Back to State Court, Bernstein Liebhard LLP Reports 2Health News:Court Overseeing Federal GranuFlo Lawsuits Remands Louisiana Claim Back to State Court, Bernstein Liebhard LLP Reports 3Health News:Court Overseeing Federal GranuFlo Lawsuits Remands Louisiana Claim Back to State Court, Bernstein Liebhard LLP Reports 4Health News:Accidental Death and Dismemberment Insurance Can Be Purchased at Low Prices Online 2Health News:California Biomedical Community Honors Senator Holly Mitchell, Assemblymembers Susan Bonilla & Kristin Olsen 2Health News:California Biomedical Community Honors Senator Holly Mitchell, Assemblymembers Susan Bonilla & Kristin Olsen 3Health News:THE ROAD by Avasa & Matthew Love -- A New Album 2Health News:THE ROAD by Avasa & Matthew Love -- A New Album 3Health News:THE ROAD by Avasa & Matthew Love -- A New Album 4
... , THURSDAY, Nov. 11 (HealthDay News) -- Many ... and dinner, meals that provide nutrients critical to youngsters, ... found. The American Dietetic Association Foundation poll of ... 17) found that breakfast is sometimes missed by 42 ...
... therapy (ADT) for prostate cancer may have an increased ... online November 10 in The Journal of the ... is a widely-prescribed treatment in men with prostate cancer, ... the adverse side effects, including osteoporosis, cardiovascular disease, diabetes ...
... 13% of the United States population, are living with ... grow. If current trends continue, there will not be ... To help address this crisis, the American Society of ... Workforce during its upcoming ASN Renal Week 2010 in ...
... and heavy drinking on college campuses continue to be ... the University of Missouri, have made strides in efforts ... trying to educate students about the risks of excessive ... who viewed images of beer cans packaged and displayed ...
... activity provides more than just pleasure, University of Cincinnati ... anxiety responses in the brain. The findings were ... PNAS , the official journal of the National ... PhD, research assistant professor, James Herman, PhD, director of ...
... By Amanda Gardner HealthDay Reporter , WEDNESDAY, Nov. ... emaciated lung cancer patients, a dead body in a morgue, ... secondhand smoke) and other consequences of smoking that will appear ... into quitting the habit or not starting in the first ...
Cached Medicine News:Health News:Many Kids Skipping Meals, Snacking Instead 2Health News:Colorectal cancer risk increases in prostate cancer patients on androgen deprivation therapy 2Health News:ASN leads efforts to address growing crisis in kidney care 2Health News:Team colors on cans change perceptions of alcohol risks, MU study finds 2Health News:Pleasurable behaviors reduce stress via brain pathways, research shows 2Health News:FDA Proposes Graphic Warnings on Cigarette Packs 2Health News:FDA Proposes Graphic Warnings on Cigarette Packs 3
(Date:1/22/2015)... , Jan. 22, 2015  Amgen (NASDAQ: AMGN ) today ... 2014 financial results on Tuesday, Jan. 27, 2015, after the close ... a conference call with the investment community at 2 p.m. PT. ... Bradway , chairman and chief executive officer, and other members of ...
(Date:1/22/2015)...  Profil Institute for Clinical Research, Inc., a clinical research ... a new textbook,  Translational Research Methods for Diabetes, Obesity ... global scientific publisher. The textbook is the ... in early phase clinical studies of new drugs for ...
(Date:1/22/2015)... Research and Markets ( http://www.researchandmarkets.com/research/3h534b/infectious ) has ... Market by Product, Application, Technology, End User - Global ... The infectious disease diagnostics market is expected ... million by 2019 from $12,422.8 million in 2014. Increase ...
Breaking Medicine Technology:Amgen Announces Webcast of 2014 Fourth Quarter and Full Year Financial Results 2New Textbook "Translational Research Methods for Diabetes, Obesity and Cardiometabolic Drug Development" Provides Critical Review Of Current And Emerging Clinical Investigation Methods 2New Textbook "Translational Research Methods for Diabetes, Obesity and Cardiometabolic Drug Development" Provides Critical Review Of Current And Emerging Clinical Investigation Methods 3Global Infectious Disease Diagnostics (Instruments, Reagents, Services, Software) Market - Forecast to 2019 2Global Infectious Disease Diagnostics (Instruments, Reagents, Services, Software) Market - Forecast to 2019 3
... 20 Pittsburgh -based Foundation Radiology Group ... proud to announce its strategic partnership with Acusis, a national provider ... , , , ... in Pittsburgh , Acusis delivers healthcare solutions that are designed ...
... 20 Medical Device Consultants, Inc. (MDCI), a ... the medical device and diagnostics industry, today announced a ... (CDSS), a clinical services and CRO based in ... to the best of both organizations, core strengths and ...
Cached Medicine Technology:Foundation Radiology Group Forms Strategic Partnership with Transcription Experts, Acusis 2Foundation Radiology Group Forms Strategic Partnership with Transcription Experts, Acusis 3Medical Device Consultants, Inc. and Clinical Development & Support Services Ltd Announce Strategic Partnership 2Medical Device Consultants, Inc. and Clinical Development & Support Services Ltd Announce Strategic Partnership 3
The ACCU-Beam® line of Surgical Microscope Accessories includes digital camera adaptors, beam splitters, objective lenses, fiber optic cables, and fiberoptic retrofits....
The ACCU-Beam® line of Surgical Microscope Accessories includes digital camera adaptors, beam splitters, objective lenses, fiber optic cables, and fiberoptic retrofits....
... of Surgical Microscope Accessories includes digital camera ... cables, and fiberoptic retrofits. TTI Medical's patented ... 5,264,928) is the only adaptor that will ... the same adaptor body. It is fully ...
... line of Surgical Microscope Accessories includes ... lenses, fiber optic cables, and fiberoptic ... Adaptor allows the surgeon to document ... either video or 35mm photography. Many ...
Medicine Products: