r. There is simply too much medical information today for one doctor or case manager to keep up on. This means medical directors and claims managers need access to outside mediIncreasingly, healthcare providers, insurers, medical directors and case managers are turning to Independent Review Organizations (IROs) to collaborate on the decision-making process for medical claims. At question, however, is when in the decision-making process does this make the most sense? Here are the top 10 signs to identify when to bring in an IRO:

1. Your case is in a highly specialized area. Case managers often need access to a breadth and depth of medical expertise beyond what is available among their staff or extended network. Information and scientific advances in the medical field are increasing at unprecedented rates. Medical disciplines fragment into new specialties every year. There is simply too much medical information today for one doctor or case manager to keep up on. This means medical directors and claims managers need access to outside medic

rocess for medical claims. At question, however, is when in the decision-making process does this make the most sense? Here are the top 10 signs to identify when to bring in an IRO:

1. Your case is in a highly specialized area. Case managers often need access to a breadth and depth of medical expertise beyond what is available among their staff or extended network. Information and scientific advances in the medical field are increasing at unprecedented rates. Medical disciplines fragment into new specialties every year. There is simply too much medical information today for one doctor or case manager to keep up on. This means medical directors and claims managers need access to outside medi

IRO:

1. Your case is in a highly specialized area. Case managers often need access to a breadth and depth of medical expertise beyond what is available among their staff or extended network. Information and scientific advances in the medical field are increasing at unprecedented rates. Medical disciplines fragment into new specialties every year. There is simply too much medical information today for one doctor or case manager to keep up on. This means medical directors and claims managers need access to outside medi

or extended network. Information and scientific advances in the medical field are increasing at unprecedented rates. Medical disciplines fragment into new specialties every year. There is simply too much medical information today for one doctor or case manager to keep up on. This means medical directors and claims managers need access to outside medir. There is simply too much medical information today for one doctor or case manager to keep up on. This means medical directors and claims managers need access to outside medical knowledge beyond their expertise. An IRO can provide such access to highly specialized doctors whose unbiased expertise is otherwise unavailable even to large healthcare companies or third-party administrators handling claims management. Because of the depth of expertise in its specialist network, and the volume and breadth of claims it reviews daily, an IRO provides a mechanism for quickly and consistently applying expert knowledge to medical claims decisions.

2. Your case has a high risk of appeal. With claims that have potential high appeal rates or other risks, health plan providers and insurers may want an external, independent and objective perspective about the claim. Using an IR