As part of a Corporate Integrity Agreement (CIA) with the Office of Inspector General (OIG), your organization may be required to undergo healthcare claims reviews. The Fox Group provides these reviews as an Independent Review Organization (IRO) to help fulfill your CIA obligations efficiently and accurately.
Purpose of a Claims Review
We conduct a claims review to verify the accuracy of your billing and coding practices, ensuring compliance with federal regulations. The review helps to identify and correct any discrepancies. This reduces the risk of non-compliance and ensures the correct processing of your claims.
Our Methodology
At The Fox Group, we conduct healthcare claims reviews with a focus on precision and compliance. We start by using RATS-STATS, the statistical software recommended by the OIG, to select a statistically valid sample of claims. We start by using RATS-STATS, the statistical software recommended by the OIG, to select a statistically valid sample of claims.
Throughout this process, we maintain a straightforward approach, prioritizing efficiency and minimizing disruption to your operations. Our team has extensive experience in healthcare operations. This ensures that our reviews are thorough and grounded in a deep understanding of the practical challenges your organization faces.
Why Choose The Fox Group?
The Fox Group’s team includes professionals with extensive experience in healthcare operations and compliance. This expertise allows us to conduct precise reviews. Our work is also informed by a deep understanding of healthcare administration’s practical aspects.
Our process is straightforward and transparent, aimed at helping your organization meet CIA requirements with minimal friction.
Data Security and Confidentiality
We prioritize the security of your data throughout the review process. We handle all information with strict confidentiality and employ advanced encryption methods to protect sensitive data.
Partner with The Fox Group
If your organization must undergo a healthcare claims review as part of a CIA, The Fox Group is ready to assist. Contact us to learn how we can help you meet your compliance obligations efficiently and effectively.
