Independent Review Organization (IRO) Services

EdiPhy Advisors, LLC

IRO Services Overview

According to NAIRO (National Association of Independent Review Organizations), an IRO provides objective, unbiased medical opinions that ensure effective decision making. IROs deliver conflict-free decisions that help clinical and claims management professionals better allocate health care resources and reduce waste.

EdiPhy Advisors provides independent review of medical necessity determinations. This service enables healthcare providers to comply with applicable regulations through appropriate application of medical necessity criteria. EdiPhy Advisors’ physician advisors maintain relevance and accuracy with the changing landscape of legal and regulatory changes in compliance requirements.

EdiPhy Advisors is a URAC-accredited IRO. Independent Review Organizations that achieve URAC accreditation are committed to a fair and impartial medical peer review process that benefits both patients and physicians. The URAC accreditation is designed to assure that Independent Review Organizations are free from conflicts of interest, establish qualifications for each physician performing independent medical peer review, address medical necessity and experimental treatment issues, and have reasonable time periods for standard and expedited peer reviews and appeals processes.


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