How to Improve Care Management Decision Making

Companies and individuals who are concerned about making sure that their members and patients get the proper healthcare are increasingly looking to independent review organizations to help them make crucial decisions about the allocation of healthcare resources according to the highest level of need.

Independent review organizations can help this process by providing for a systematic review of all complex and costly medical claims to determine whether or not the treatments that have been prescribed are medically necessary, are appropriate, and are aligned with the accepted standards of care. Independent review organizations are playing an increasingly important role in containing escalating healthcare costs by assuring that health care resources are only allocated to those patients and members who actually deserve them. Independent review organizations provide a key balancing force between payers and patients to assure that patients get the healthcare that they are supposed to every time. At the same time, an IRO assures that no unnecessary treatments are authorized are burdening and adding costs to the health care system in general. An independent review organization provides a critical look at the nexus of the health care decision-making chain in order to improve the delivery of healthcare to all members and patients in a health plan.

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. AllMed's growing customer base for its independent medical review and hospital peer review services includes premier organizations, such as Educator's Mutual Life, IMS Managed Care, Tenet Healthcare Corporation, HealthGuard, several Blue Cross Blue Shield organizations, TriWest Healthcare Alliance, Allianz and many other leading healthcare payers. Read the AllMed Medical News Blog and the Independent Review Organization Blog.

Article Source: http://EzineArticles.com/?expert=Skip_Freedman