Independent review organization (IRO) assignment instructions

Under RCW 48.43.535 and RCW 43.70.235, consumers have a right to an independent review, if upon completion of the grievance process they are not satisfied with the health carrier's decision. Independent reviews must be completed within 72 hours for expedited reviews and 15 days for non-expedited reviews.

What coverage types are affected?

Assignment instructions

When you receive an independent review request you'll assign an independent review organization (IRO) using the following criteria:

  1. For first-time requests, select the first IRO listed (#1); if there's a conflict, select the next IRO listed (#2).
  2. For subsequent requests, select the next IRO listed unless there's a conflict.
  3. After using the last IRO, return to the top of the list and repeat the process.
  4. After you've contacted the IRO, complete an IRO Assignment form and submit it to us within three business days of the assignment.

List of certified independent review organizations

Assignment #1

  IPRO - Certification #2001-02-A  

1979 Marcus Avenue
PO Box 33400
Lake Success, NY 11042

Phone: 516-326-7767, ext. 223
Fax: 516-326-1034
Website: www.ipro.org

Terese Giorgio, RN, BSN, MA, LNC
Senior Director, Corporate Programs

Email: tgiorgio@ipro.org

Frank E Laquinta, MD
Medical Director, Health Care Assessment

Email: fiaquinta@ipro.org

 

Assignment #2

  IMEDECS - Certification #2001-04-A

Deahna Montaque
100 West Main Street, Suite 310
Lansdale, PA 19446

Phone: 215-855-4633
Fax: 215-855-5318
Website: www.imedecs.com

 

Assignment #3

  Virginia Health Quality Center - Certification #2001-05-A

9830 Mayland Drive, Suite J
Richmond, VA 23233

Phone: 804-289-5320
Fax: 804-289-5324
Website: www.vhqc.org

Jaime Walker, RN
Clinical Review Specialist

Phone: 804-289-5320
Fax: 804-289-5324
Website: www.vhqc.org

Marcy Gillespie
Director, Clinical Review Services

Phone: 804-289-5320
Fax: 804-289-5324
Website: www.vhqc.org

Sallie S. Cook, MD
Chief Medical Officer

Phone: 804-289-5320
Fax: 804-289-5324
Website: www.vhqc.org

 

Assignment #4

  Medical Review Institute of America, Inc - Certification #2001-06-

2875 South Decker Lake Dr, Suite 300
Salt Lake City, UT 84119

Toll-free: 800-654-2422
Phone: 801-261-3003
Fax: 801-261-3189

Aja Ogzewalla, Director of Regulatory Compliance

Toll-free: 800-654-2422, ext. 6475

 

Assignment #5

  Center for Health Dispute Resolution / MAXIMUS, Inc - Certification #2001-07-A

MAXIMUS Federal Services, Inc.
3130 Kilgore Road, Suite 400
Rancho Cordova, CA 95670

Phone: 916-364-8146
Fax: 916-364-2001

 

Assignment #6

  AllMed Healthcare Management - Certification #2001-02-A  

621 SW Alder St, Suite 740
Portland, OR 97205

Toll-free: 800-400-9916
Phone: 503-274-9916
Fax: 503-223-6244
Website: www.allmedmd.com

Skip Freedman, MD
President/Medical Director

Email: skipfree@allmedmd.com

Karen Freedman, PT
Director of Professional Standards

Email: karen@allmedmd.com

Chris Senz, Privacy officer
Director of Professional Standards

Email: chris@allmedmd.com

 

Assignment #7

National Medical Reviews, Inc - Certification #2005-01-A

260 Knowles Avenue, Suite 330
Southampton, PA 19053

Phone: 215-352-7800
Fax: 215-352-7801
Email: medreviews@nmrusa.com

Elaine Nace, Esq., CHC
Director of Compliance, Regulatory Affairs & Quality Management

Email: enace@nmrusa.com

Carol Barrett, RN
Review Coordinator

June McClernon
Review Coordinator

Michael Ziev, D.O.
Chief Medical Director

Phone: 215-352-7800 ext. 111
Email: cbarrett@nmrusa.com

Phone: 215-352-7800 ext. 100
Email: jmcclernon@nmrusa.com

Phone: 215-352-7800 ext. 100
Email: mziev@nmrusa.com

 

Assignment #8

  MCMC - Certification #2005-02-A

5272 River Road, Suite 650
Bethesda, MD 20816

5272 River Road, Suite 650 Bethesda, MD 20816

5272 River Road, Suite 650
Bethesda, MD 20816

Email: joelle.georges@mcmcllc.com

5272 River Road, Suite 650
Bethesda, MD 20816

Email: gabrielle.susi@mcmcllc.com

 

Assignment #9

Advanced Medical Reviews - Certification #2008-01-A

10780 Santa Monica Boulevard, Suite 333
Los Angeles, CA 90025

Phone: 800-726-1207, Option 1
Fax: 310-765-6261

Elizabeth Davis

Email: states@admere.com
Website: www.admere.com

Dr. Eytan Alpern
Chief Executive Officer

 

 

Assignment #10

  Medical Consultants Network - Certification #2011-01-A

901 Boren Ave Ste 1400
Seattle, WA 98104

Phone: 206-621-9097
Fax: 206-623-4956

Erik Halse, Peer Review Product Manager

Email: ehalse@mcn.com

 

Assignment #11

IMX Medical Management Services - Certification #2012-10-A  

1700 Paoli Pike
Malvern, PA 19355

Phone: 484-329-7000, ext 7070
Fax:484-329-7095

Direct: 484-329-7070

Darcy Saunders, Director - IRO Program

Email: darcy.saunders@imxmed.com

 

Assignment #12

 MET Healthcare Solutions - Certification #2013-01-A

1225 North Loop West, Suite 1055
Houston, Texas 77008

Toll-free: 800-845-8982 ext 231
Fax: 713-961-7286

Stacy Jones, Vice President

Email: sjones@medevaltx.com
Alternate Email: irodecisions@medevaltx.com

 

Assignment #13

H.H.C. - Certification #2014-01-A

Roffe Enterprises/H.H.C. Group
438 North Frederick Avenue #200
Gaithersburg, MD 20877-2432

Phone: 301-963-0762
Fax: 301-963-9431

JB Lee, J.D.
Assistant General Counsel/Medicare Compliance Officer

Email: mailto:jblee@hhcgroup.com

After hours emergency/expedited referrals

Email: IRO_after_hour_referral@hhcgroup.com
Phone: 301-963-0762, ext. 214

 

Assignment #14

 ProPeer Resources, Inc. - Certification #2014-02-A

500 North Marketplace Drive, Suite 202

P.O. Box 1148

Centerville, UT 84014

Toll-free: 800-292-3051
Fax: 801-292-3299

Richard Lynch, President

Email: RLynch@propeer.com

Toll-free: 800-292-3051

 

 

Updated 06/06/2014

See also

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