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EdiPhy Advisors, LLC

Independent Review Organization (IRO) Services Overview

According to NAIRO (National Association of Independent Review

Organizations), an IRO provides objective, unbiased medical opinions

that ensure effective decision making. IROs deliver conflict-free

decisions that help clinical and claims management professionals better

allocate health care resources and reduce waste.

EdiPhy Advisors provides independent review of medical necessity

determinations. This service enables healthcare providers to comply with

applicable regulations through appropriate application of medical

necessity criteria. EdiPhy Advisors’ physician advisors maintain

relevance and accuracy with the changing landscape of legal and

regulatory changes in compliance requirements.

EdiPhy Advisors is a URAC-accredited IRO. Independent Review

Organizations that achieve URAC accreditation are committed to a fair

and impartial medical peer review process that benefits both patients

and physicians. The URAC accreditation is designed to assure that

Independent Review Organizations are free from conflicts of interest,

establish qualifications for each physician performing independent

medical peer review, address medical necessity and experimental

treatment issues, and have reasonable time periods for standard and

expedited peer reviews and appeals processes.

“Be a yardstick of quality. Some people aren’t used to an environment where excellence is expected.”

— Steve Jobs, co-founder of Apple Computer

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