IRO Responsibilities. The IRO shall:
1. perform each Claims Review in accordance with the specific requirements of the CIA;
IRO Responsibilities. The IRO shall:
1. perform each Arrangements Review in accordance with the specific requirements of the CIA;
2. respond to all OIG inquires in a prompt, objective, and factual manner; and
3. prepare timely, clear, well-written reports that include all the information required by Appendix B to the CIA.
IRO Responsibilities. The IRO shall:
1. perform each Quarterly Claims Review in accordance with the specific requirements of the IA;
IRO Responsibilities. The IRO shall:
IRO Responsibilities. The IRO shall:
1. perform each Inpatient Medical Necessity and Appropriateness Review and Unallowable Cost review in accordance with the specific requirements of the CIA;
IRO Responsibilities. The IRO shall:
1. perform each Claims Review in accordance with the specific requirements of the CIA;
2. follow all applicable Medicare and TRICARE rules and reimbursement guidelines in making assessments in the Claims Review;
3. request clarification from the appropriate authority (e.g., Medicare contractor), if in doubt of the application of a particular Medicare or TRICARE policy or regulation;
4. respond to all OIG inquires in a prompt, objective, and factual manner; and
5. prepare timely, clear, well-written reports that include all the information required by Appendix B to the CIA.
IRO Responsibilities. A. The Interventional Cardiac Procedures IRO shall:
1. perform each Interventional Cardiac Procedures Review in accordance with the specific requirements of the CIA;
IRO Responsibilities. The IRO shall:
1. perform each Promotional and Product Services Review in accordance with the specific requirements of the CIA;
IRO Responsibilities. The IRO(s) shall:
1. perform each Claims and Cardiac Procedures Review in accordance with the specific requirements of the IA;
IRO Responsibilities. The IRO shall:
1. perform each Claim Review, the Unallowable Cost Review, and the Stat Lab Systems Review in accordance with the specific requirements of the CIA;
2. follow all applicable Medicare rules and reimbursement guidelines in making assessments in the Claims Review, and Stat Lab Systems Review;
3. if in doubt of the application of a particular Medicare policy or regulation, request clarification from the appropriate authority (e.g., fiscal intermediary or carrier);
4. respond to all OIG inquires in a prompt, objective, and factual manner; and
5. prepare timely, clear, well-written reports that include all the information required by Appendixes D and E.
