Corporate Integrity Agreement (CIA) Support/Independent Review Organization
Entities and healthcare providers who find themselves under a Corporate Integrity Agreement (CIA) are aware that there are a number of items and obligations that must be complied with. A common component of CIAs is the requirement to engage an Independent Review Organization (IRO) to conduct claims and/or arrangements reviews. Having served as the IRO for several organizations, ACI understands the importance of these responsibilities. In addition to compliance expertise, ACI can also provide clinical expertise to comply with the CIA terms that require a clinical review of medical necessity. ACI's IRO proficiencies include claims, arrangement and medical necessity reviews.
Our experience as an IRO provides our clients with the expertise necessary to manage IRO engagements effectively and efficiently by working in tandem with the OIG, legal counsel and the entity or individual.
If the CIA requires engagement of a compliance expert, we are uniquely qualified to fill that role. Even when this is not a required element of the CIA, engaging us to support your implementation efforts, provide "mock" IRO audits and just overall support is another area clients have found our work of great value.