Our Services
From routine authorization decisions to complex specialty cases and appeals, OneIRO provides objective clinical expertise tailored to the needs of each case.
Physician Peer Review
First-Level or Second-Level Appeals with a same- or similar-specialty-matched physician. Peer-to-Peer available upon request.
Federal & State External Reviews
Final level of appeal requested at the health plan level or by the applicable Department of Insurance. Completed by a same or similar matched reviewer. Acknowledgement letters and notifications are issued per specific state and federal regulations, time frames, and guidelines.
PriorAuth/Pre-Cert
Non-specialty matched based on criteria completed by RN, Pharmacist, and/or Physician.
Quality of Care Reviews / SIU
Same or similar specialty matched reviews that address whether the quality of the services provided is consistent with professionally recognized standards of care. We can perform individual reviews or a series of cases. We will work with you on the questions to be addressed and the format of the review report.