IRO Services Overview

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Choosing the right Independent Review Organization (IRO) is crucial for a healthcare entity entering a Corporate Integrity Agreement (CIA). 

At The Fox Group, we blend deep healthcare operational expertise with comprehensive compliance auditing to offer tailored IRO services. Our team, comprising former healthcare operators rather than just auditors, understands firsthand the challenges you face. We prioritize efficiency, data security, and personalized service to assist your organization in meeting or exceeding OIG requirements, setting you on a clear path to compliance.

 

Why Choose The Fox Group for Your IRO Services?

The Fox Group specializes in providing IRO services with a difference. As mentioned, our foundation is built on a deep understanding of the healthcare operations landscape. Unlike traditional audit-centric models, our team is comprised exclusively of professionals with firsthand experience in healthcare administration, management, billing, and coding. This operational expertise allows us to approach each review with a unique perspective – one that blends empathy with efficiency.

We recognize our clients’ daily challenges and pressures because we've been there. Our approach is not just about checking boxes; it's about understanding the intricacies of your operations and the impact of compliance requirements on your day-to-day activities. Our team's background ensures that we can relate to your situation.

However, our empathy enhances rather than compromises our dedication to rigorous standards. On your behalf, we actively ensure that your CIA mandates are met with unmatched precision and integrity. Our balanced methodology means that while we understand the operational realities of your organization, we maintain an unwavering focus on compliance, providing the reassurance that your obligations are fulfilled to the highest standard.

The Fox Group bridges the gap between operational know-how and audit excellence. We're not just auditors; we're your partners in navigating the complexities of compliance with understanding, professionalism, and meticulous attention to detail.

 

Common Types of Audits Under a CIA with the OIG

IROs play a critical role in implementing the intent of Corporate Integrity Agreements through specialized reviews. These reviews focus on issues from settlements with the U.S. Government.

Each CIA addresses specific concerns within an organization that may commonly result in claims, arrangements, and/or systems reviews among others. Those reviews will then focus on ensuring compliance with regulations such as anti-kickback statutes, ethical marketing, accurate billing, and more.

The IRO role is pivotal in helping healthcare organizations maintain organizational integrity, prevent future compliance issues, and promote transparency and accountability. However, as the IRO, we cannot act as consultants to a client and train staff on issues such as billing and coding. Still, within our IRO reports and spreadsheets, we create a learning environment for providers and staff members.  We deliver detailed notes, findings, and recommendations so that clients can utilize our report as a guide to correct their mistakes and decrease their error rate.

 

The Fox Group Advantage: Unpacking Our IRO Service Features

The Fox Group is a versatile IRO, experienced in diverse settings under corporate integrity agreements. And our nearly 20 years as a healthcare IRO have uniquely positioned us to help you meet the requirements of your CIA.

You will appreciate the unique benefits that The Fox Group brings to your organization, structured around our key service features. Each supports your needs, offering tailored solutions that address the challenges of maintaining compliance with your Corporate Integrity Agreement.

 

Feature: Our extensive experience as an OIG approved independent review organization across a multitude of healthcare service lines.

  • Benefit: The process of complying with the CIA is daunting, especially since it is the first time a provider is encountering it. As an experienced IRO, we can clarify the process and help you better comply with it.
  • Outcome: A simplified, more streamlined experience that is less taxing on your staff and more efficient.

Feature: Our Experience as Healthcare Operators.

  • Benefit: Provides clients with advisors who possess a firsthand understanding of healthcare operations, not just theoretical knowledge.
  • Outcome: Bridges the gap between compliance requirements and practical, operational realities, ensuring ensuring audits align closely with both needs and regulations.

Feature: Our Decades of Experience Across Diverse Healthcare Settings that Include Medical Practices, Acute Care Hospitals, Long-term Care Organizations, Therapy Clinics, Labs, Pharmacies, and more.

  • Benefit: We bring a wealth of knowledge and adaptability to any healthcare environment due to our familiarity with countless operational landscapes.
  • Outcome: Ensures tailored and informed audit processes that minimize workplace disruption.

Feature: Advanced Data Security and Privacy with 256-bit SSL and AES Encryption for All Correspondence and Document Cloud Storage.

  • Benefit: Ensures that all client data is handled with the highest standards of confidentiality and security.
  • Outcome: Strictly adheres to laws and concerns over patient privacy and data security during the audit process.

Feature: We Put a Premium on Clear Communication and Support.

  • Benefit: Simplifies a potentially complex IRO process, making it understandable and more palatable for clients. 
  • Outcome: This approach clarifies the audit process and its outcomes for clients. It addresses concerns about confidently understanding findings and where to implement change when needed.

Feature: Cost-Effective Solutions.

  • Benefit: Offers competitive pricing and transparent cost structures to provide value without compromising quality.
  • Outcome: Helps to mitigate concerns about IRO costs, enabling healthcare entities of all sizes to comply with CIA requirements.

Feature: We Have over 3 Decades of Comprehensive Compliance Expertise.

  • Benefit: Access to a team with diverse backgrounds, including regulatory, clinical, and operational expertise.
  • Outcome: Ensures a thorough understanding of the regulatory environment and practical application of compliance measures, directly addressing the challenge of finding a qualified IRO.

 

Learn More About How We Can Help to Meet your CIA Obligations

View Our 7-Minute IRO Presentation Now

If your business requires the services of an independent review organization, please contact us and we will quickly arrange for an introductory call.

You can also look through the FAQs listed below.  To learn more about our compliance consulting services, including compliance program policies and procedures, visit our Compliance & HIPAA Services page.

 

Frequently asked questions about an IRO or a CIA:

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