IRO Responsibilities Sample Clauses
The 'IRO Responsibilities' clause defines the duties and obligations of the Independent Review Organization (IRO) engaged under the agreement. Typically, this clause outlines the scope of the IRO's work, such as conducting audits, monitoring compliance, or providing reports to the parties involved. For example, it may specify timelines for submitting findings, standards for impartiality, or requirements for maintaining confidentiality. The core function of this clause is to ensure that the IRO's role is clearly delineated, promoting accountability and transparency in the review process.
IRO Responsibilities. The IRO shall:
1. perform each Claims Review in accordance with the specific requirements of the CIA;
IRO Responsibilities. The IRO shall:
1. perform each Arrangements Review in accordance with the specific requirements of the CIA;
2. respond to all OIG inquires in a prompt, objective, and factual manner; and
3. prepare timely, clear, well-written reports that include all the information required by Appendix B to the CIA.
IRO Responsibilities. The IRO shall:
1. perform each Quarterly Claims Review in accordance with the specific requirements of the IA;
IRO Responsibilities. The IRO shall:
IRO Responsibilities. The IRO shall:
1. perform each Inpatient Medical Necessity and Appropriateness Review and Unallowable Cost review in accordance with the specific requirements of the CIA;
IRO Responsibilities. The IRO shall:
1. perform each Claims Review in accordance with the specific requirements of the CIA;
2. follow all applicable Medicare and TRICARE rules and reimbursement guidelines in making assessments in the Claims Review;
3. request clarification from the appropriate authority (e.g., Medicare contractor), if in doubt of the application of a particular Medicare or TRICARE policy or regulation;
4. respond to all OIG inquires in a prompt, objective, and factual manner; and
5. prepare timely, clear, well-written reports that include all the information required by Appendix B to the CIA.
IRO Responsibilities. A. The Interventional Cardiac Procedures IRO shall:
1. perform each Interventional Cardiac Procedures Review in accordance with the specific requirements of the CIA;
IRO Responsibilities. The IRO shall:
1. perform each Promotional and Product Services Review in accordance with the specific requirements of the CIA;
IRO Responsibilities. The IRO(s) shall:
1. perform each Claims and Cardiac Procedures Review in accordance with the specific requirements of the IA;
IRO Responsibilities. The IRO shall:
1. perform each Cost Reporting Engagement, Unallowable Cost Review, and Billing Engagement in accordance with the specific requirements of the CIA;
2. follow all applicable Medicare rules and reimbursement guidelines in making assessments in the Billing Engagement;
3. if in doubt of the application of a particular Medicare policy or regulation, request clarification from the appropriate authority (e.g., fiscal intermediary or carrier);
4. respond to all OIG inquiries in a prompt, objective, and factual manner; and
5. prepare timely, clear, well-written reports that include all the information required by Appendix B.