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An IRO can provide such access to highly specialized doctors whose unbiased expertise is otherwise unavailable even to large healthcare companies or third-party administrators handling claims management. Because of the depth of expertise in its specialist network, and the volume and breadth of claims it reviews daily, an IRO provides a mechanism for quickly and consistently applying expert knowledge to medical claims decisions. 2. Your case has a high risk of appeal. With claims that have potential high appeal rates or other risks, health plan providers and insurers may want an external, independent and objective perspective about the claim. Using an IRO to decide cases based on medical need avoids the appearance that the case review might be tainted by potential biases of a doctor on their payroll, or even the financial goals of the insurer or administrating group. 3. Your case may be litigated. 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There is increasing pressure on payers and plan administrators to not only make the right decision for the patient but also reduce healthcare insurance costs, premiums and co-payments. To make this happen, many health insurers and third-party administrators are turning to IROs for deeper medical expertise, and approval or denial of a claim based on medical fact, not anecdotal evidence. Using an IRO is an efficient and defensible way to manage a health plan properly for both the insurer and the patient. As unbiased advocates for managing healthcare costs, IROs ensure that every claimant is properly served, every time. About AllMed Healthcare Management Founded in 1995, AllMed is a URAC-accredited Independent Review Organization (IRO) serving insurance payers, providers, TPAs and claims managers nationwide. Reviews are conducted by board-certified physicians in active practice. 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