Examples of Independent Review Organization (IRO in a sentence
An explanation that you may ask for an external review with an Independent Review Organization (IRO) not associated with Blue Cross and Blue Shield if your appeal was denied based on any of the reasons below.
The Independent Review Organization (IRO) will notify the Insured Person of the determination within 72 hours.
If Your claim is not eligible for external review, we will outline the reasons it is ineligible in the notice, and provide contact information for the Department of Labor’s Employee Benefits Security Administration (toll-free number 1-866-444-EBSA (3272)) and or state consumer ombudsman as appropriate.3. Referral to Independent Review Organization (IRO).
Denials based on Experimental/Investigational services and supplies are Adverse Determinations and are subject to the utilization review process, including reviews by an Independent Review Organization (IRO) as described in the Complaint and Appeals section.
When a request is complete and eligible for an EER, the Commissioner shall immediately assign an Independent Review Organization (IRO) from the Commissioner’s approved list and notify the Company of the name of the assigned IRO.
Denials based on Experimental/Investigational services and supplies are Adverse Determinations and are subject to the utilization review process, including reviews by an Independent Review Organization (IRO) as described in the COMPLAINT AND APPEALS section.
Denials based on Experimental/Investigational services and supplies are Adverse Determinations and are subject to the utilization review process, including reviews by an Independent Review Organization (IRO) as described in the Complaint and Appeal Procedures section.5. Any charges resulting from the failure to keep a scheduled visit with a Participating Provider or for acquisition of medical records.6. Special medical reports not directly related to treatment.
An Expedited External Appeal is a request for immediate review, by an Independent Review Organization (IRO).
Expedited External Appeal – A request for immediate review, by an Independent Review Organization (IRO), of an initial Adverse Benefit Determination, which involves any of the following: A.
Assign an Independent Review Organization (IRO) from the Commissioner’s approved list; b.