IRO Services Overview

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The services of an Independent Review Organization (IRO) are integral to most Corporate Integrity Agreements (CIA).  Healthcare and other organizations that enter into a CIA with the government are required to retain an IRO, usually to review a sample of the claims the organization is submitting to Federal healthcare programs.  IRO audits may also include an operational review of the organization’s process for compiling and submitting claims, including coding and medical necessity.

Our years of experience as a healthcare IRO have uniquely positioned us to help you meet the requirements of your CIA. Not only is The Fox Group a qualified IRO well versed in working with corporate integrity agreements, but we have provided IRO services for a wide variety of healthcare entities. These include medical practices, institutional providers, retail pharmacies, and more. Add to that our years of experience in healthcare compliance consulting, and you will be hiring a team of knowledgeable, fair, and well-versed professionals.

Is an IRO a ‘policing agency’?

Sometimes this question is asked: “Is an IRO a ‘policing agency’ for the Office of Inspector General (OIG).”

No, The Fox Group, working as your IRO, is not a ‘policing agency’ for the Office of Inspector General (OIG). We are the liaison between the OIG and the client. Once a client signs an engagement agreement with The Fox Group, our goal is to work as a team to assist the client in completing their Corporate Integrity Agreement requirements.

As the IRO, we cannot act as the consultant to a client and train staff on issues such as billing and coding. However, within our IRO reports and spreadsheets, we create a learning environment for providers and staff members.  We provide detailed notes, findings, and recommendations so that clients can utilize our report as a guide to correct their mistakes and decrease their error rate.

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If your business requires the services of an independent review organization, please look through the FAQs listed below.  To learn more about our compliance consulting services, including compliance program policies and procedures, please visit our Compliance & HIPAA Services page.

Frequently asked questions about an IRO or a CIA:

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