Review, monitor and improve compliance with Corporate Integrity Agreement (CIA) guidelines.
Our IRO reviews identify risk areas in your organization and recommended strong solutions to help providers improve compliance. With our IRO reviews, we’ll enhance your compliance programs and monitor their adherence to the CIA requirements. We also provide the expertise for revamping billing compliance protocols, mitigating future risk, and reducing fraud and abuse to improve the overall operational quality for our clients.
Request more information on our Independent Review Organization services and IRO reviews.
The McBee Advantage
Our compliance experts conduct an eligibility review, level of service review and, if needed, a system review according to the standards prescribed by the Office of the Inspector General (OIG) in the CIA. We present the review methodology (including data used), findings, and any recommendations to improve documentation and minimize overall risk. Our findings are an important training tool for adherence to billing and medical documentation requirements to avoid government enforcement actions pertaining to fraud & abuse and reduce repayment penalties.
- Develop and implement an IRO work plan in accordance with CIA requirements
- Identify, document, and facilitate as required under the OIG’s Corporate Integrity Agreement
- Prepare a final report with a quantitative and qualitative assessment of compliance to the regulatory requirements
- Recommend efficient communication between your organization and OIG
Decades of Industry Experience. Solutions that Empower.
Request more information on our Independent Review Organization services and IRO reviews.
Frequently Asked Questions About Independent Review Organization Services
An IRO is a third-party firm that reviews a healthcare provider’s compliance with billing, documentation and coding requirements. Such an examination is usually performed as part complying with a Corporate Integrity Agreement (CIA) issued by the Office of Inspector General (OIG). The goal is to identify risks, verify accuracy and recommend corrective actions that reduce the chance of future penalties or enforcement.
Mock surveys help identify gaps in compliance before they escalate into major regulatory violations. By addressing problems early (like improper documentation or inconsistent billing) organizations can reduce the risk of fines, audit findings or federal oversight agreements like CIAs. Learn more from McBee experts in our blog Avoid CIAs and Maintain Compliance with Internal Mock Survey Audits.
McBee performs eligibility reviews, level of service assessments and, when required, systems reviews. These evaluations are tailored to meet OIG guidelines; they include detailed reporting, corrective action planning and support for ongoing compliance efforts.
No. While large health systems may use IRO services more frequently due to regulatory exposure, McBee works with organizations of all sizes. We’re especially skilled at helping home health agencies, hospices, skilled nursing facilities and physician groups.
Providers can work toward improved documentation accuracy, better internal oversight, reduced compliance risk, and clear, data-supported insights into how their billing and clinical processes align with federal standards. The IRO review process also helps support stronger communication with regulators and helps avoid future audit issues.