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WebThe National Association of Independent Review Organizations (NAIRO) is an industry trade association formed in 2000. NAIRO is comprised of URAC accredited Independent …

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URL: https://www.nairo.org/

A Consumer’s Guide to Navigating the External Review …

WebPO Box 28402 · Portland, OR 97228 · www.nairo.org Information on various health insurance programs and how they relate to external appeals.

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NAIRO RELEASES ROADMAP TO GUIDE RIGOROUS CLINICIAN …

WebIROs and UR/UM entities utilize comprehensive credentialing and re-credentialing programs to ensure a fair and accurate review process. “The act of credentialing is a core concept …

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As Health Plans Outsource Operations, Independent Review

WebAs Health Plans Outsource Operations, Independent Review Organizations (IROs) Step In to Fulfill Key Duties Health plans are increasingly turning to IROs to provide internal appeal

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PO Box 28402 · Portland, OR 97228 · www.nairo

WebPO Box 28402 · Portland, OR 97228 · www.nairo.org ERISA or self-funded plans (as of July 1, 2012 pursuant to Technical Release 2011-02) are required under

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PRESERVING THE INTEGRITY AND VIABILITY OF MEDICAL …

Web3. Key elements of independent review are independent expertise and prompt action. 4. Independent review upholds health plan decisions about as frequently as it overturns …

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NAIRO Calls on California to Eliminate Onerous ‘Duty of …

WebEffective January 1, 2022, the No Surprises Act (NSA) ushered in sweeping changes to the dispute-resolution process between healthcare providers and payers, establishing a …

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Restrictive State Laws Can Compromise the Integrity of

WebPO Box 28402 · Portland, OR 97228 · www.nairo.org Table 1. States with laws restricting IRO use, external review State Rule and Citation Missouri Missouri Annotated Statutes, …

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Accredited, Compliant IROs Lead the Way to Fair and …

Web2 association of health benefit plans, or a national, State or local trade association of health care providers.” Further, URAC accreditation standards mandate certain requirements …

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Fair IDR: The Way Forward To Protect Patients & Resolve Surprise

WebFair IDR: The Way Forward To Protect Patients & Resolve Surprise Medical Bill Disputes. Protecting patients from surprise medical bills is a national concern. 1 The stories of …

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NAIRO INSTALLS 2019-21 EXECUTIVE OFFICERS

WebNAIRO’s 2019-21 Executive Officers include: President: Ed Bolton. Mr. Bolton is the Founder and CEO of Nexus Medical, a national clinical review organization that has …

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Mastering External Appeals 20130724

Web7/22/2013 1 Mastering External Appeals A Guide for Health Plans July 24, 2013 Audio: 800-868-1837 Participant Pin: 414115# Webinar Questions for the Speakers

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Know Your Healthcare Appeal Rights:

WebThe internal appeal may have no more than two steps: a first-level and a second-level (if required) internal appeal. In many health plans, internal appeals are reviewed by …

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A VISION FOR IMPROVING HEALTHCARE IN AMERICA

Web4 interest, stress evidence-based medicine, show objective decision-making and ensure consumers are getting the care they pay for. As a first step toward making the healthcare …

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Mental Health Parity Law in Calif. Signals Shift in Review Industry

WebA mental health parity law that took effect in California on January 1, 2021, means that independent review organizations (IRO) and utilization review organizations (URO) can …

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