URAC Accreditations & Other Partnerships
EdiPhy Advisors is URAC accredited as an Independent Review Organization (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 peer reviews and appeals processes.
EdiPhy Advisors is recognized by the Microsoft Partner Network as having Silver Application Development Competency.
Independent Review Organization
Microsoft Certified Partner
HIPAA EDI (Electronic Data Interchange) Compliant
The HIPAA Electronic Data Interchange rule requires all entities that electronically transmit PHI (personal health information) data to do so in accordance with the X12N EDI data transmission protocol standard. EdiPhy Advisors supports and maintains compliance with this rule that was designed to allow both Medicare and health care providers to “process transactions faster and at a lower cost” (CMS.gov, Electronic, Billing & EDI Transactions).
National Association of Independent Review Organizations (NAIRO) Member
According to the NAIRO web site: “The National Association of Independent Review Organizations (NAIRO) was formed by the majority of URAC-accredited independent review organizations (IRO). NAIRO is comprised of 32 members and is dedicated to protecting the integrity of the independent medical peer review processes. Utilizing the expertise
of thousands of board-certified clinicians throughout the country, NAIRO members embrace an evidence-based approach to independent medical peer review, in order to help resolve coverage disputes between enrollees and their health plans.”