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