Independent review organizations definition

Independent review organizations means an organiza- tion certified under s. 632.835 (4), Stats.
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Independent review organizations means an organization certified under s. 632.835 (4),
Sample 1

Examples of Independent review organizations in a sentence

  • Independent review organizations (“IRO”) are selected by the DFR and must not have any conflict of interest associated with the review.

  • Independent review organizations shall maintain all records concerning external reviews for at least three years after conclusion of each external review.

  • Independent review organizations are entities that conduct independent external review of adverse benefit determinations.

  • Independent review organizations as defined in section 3922.01 of the Revised Code seeking accreditation or accredited by the superintendent to conduct external reviews on behalf of health plan issuers on or after January 1, 2012.

  • Formerly RCW 43.70.235.] Savings clause—Automatic certification—2016 c 139: "(1) Independent review organizations remain subject to RCW 48.43.537, as it existed on January 1, 2016, and the rules adopted by the department of health under that section through December 31, 2016.

  • Independent review organizations shall be designated by the carrier, and the independent review organization chosen shall not own or control, be a subsidiary of, or in any way be owned or controlled by, or exercise control with a health insurance plan, a national, state, or local trade association of health insurance plans, and a national, state, or local trade association of health care providers.

  • A statement of recommended standards for legal reviewers could take substantially the following form: Independent review organizations will establish and implement criteria for the number and qualifications of required legal reviewers considering the population served.

  • Independent review organizations seeking accreditation or accredited by the superintendent to conduct external reviews on behalf of health insuring corporations, insurers, and public employee benefit plans on or after May 1, 2000.

  • Independent review organizations that are certified as of December 31st of the calendar year will be re­ quired to submit an annual recertification, using the commissioner's online service, no later than March 31st of the following calendar year.

  • Where there is a verb inflected with a first- or second-person marker, then coreferential independent pronouns cannot occur in the same intonational phrase (Baker 2002: 60–61).

Related to Independent review organizations

  • Independent review organization means an entity that is accredited to conduct independent external reviews of adverse benefit determinations.

  • Review organization means a disability insurer regulated

  • Utilization review organization means an entity that conducts utilization review, other than a health carrier performing a review for its own health benefit plans.

  • independent review committee means the independent review committee of the investment fund established under National Instrument 81-107 Independent Review Committee for Investment Funds;

  • Managed care organization means an entity that (1) is under contract with the department to provide services to Medicaid recipients and (2) meets the definition of “health maintenance organization” as defined in Iowa Code section 514B.1.

  • Professional employer organization means an employee leasing

  • Managed Care Organization (MCO) means a contracted health delivery system providing capitated or prepaid health services, also known as a Prepaid Health Plan (PHP). An MCO is responsible for providing, arranging, and making reimbursement arrangements for covered services as governed by state and federal law. An MCO may be a Chemical Dependency Organization (CDO), Dental Care Organization (DCO), Mental Health Organization (MHO), or Physician Care Organization (PCO).

  • Procurement organization means an eye bank, organ procurement organization, or tissue bank.

  • Provider Organization means a group practice, facility, or organization that is:

  • Member organization means any individual, corporation, limited liability company, partnership, or association that belongs to an association.

  • Nonprofit organization means a university or other institution of higher education or an organization of the type described in section 501(c)(3) of the Internal Revenue Code of 1954 (26 U.S.C. 501(c) and exempt from taxation under section 501(a) of the Internal Revenue Code (25 U.S.C. 501(a)) or any nonprofit scientific or educational organization qualified under a state nonprofit organization statute.

  • Architectural Review Committee or “ARC” shall mean the architectural review committee established by the Organization to review plans submitted to the Organization for architectural review.

  • Independent System Operator means a person that may receive or has received, by transfer pursuant

  • Stewardship organization means an organization, association, or

  • Designated chemical dependency specialist means a person

  • Business organization means an individual, partnership, association, joint stock company, trust, corporation or other legal business entity or successor thereof.

  • Supervisory Review means ongoing clinical case reviews in accordance with procedures developed by ADMINISTRATOR, to determine the appropriateness of Diagnosis and treatment and to monitor compliance to the minimum ADMINISTRATOR and Medi-Cal charting standards. Supervisory review is conducted by the program/clinic director or designee.

  • Supervised financial organization means a person, other than an insurance company or other organization primarily engaged in an insurance business:

  • Independent Evaluator A person empowered, pursuant to Section 23.5 (Failure to Reach Agreement) and Section 23.10 (Dispute) of this Agreement, to resolve disputes due to failure of the Parties to agree on a Performance Standards Revision Document.

  • Independent Party means, with respect to a BDC Downstream Fund, (i) if the BDC Downstream Fund has a board of directors (or the equivalent), the board or (ii) if the BDC Downstream Fund does not have a board of directors (or the equivalent), a transaction committee or advisory committee of the BDC Downstream Fund.

  • Organ procurement organization means a person designated by the Secretary of the United States Department of Health and Human Services as an organ procurement organization.

  • Drug utilization review means an evaluation of a prescription drug order and patient records for