Healthcare Services

5 Reasons Why You Need an IRO Even If You Aren’t Under a CIA

5 Reasons Why You Need an IRO Even If You Aren’t Under a CIA

By Jim Bobeck

 

  1. Build the ark before it rains, not after. Many companies wait for litigation to hit their door before retaining external IRO auditing services. Companies assume ‘”it will never be us”…until it’s them. Self-reporting provides far better outcomes than OIG investigations. It doesn’t take much effort to start now, but it takes a whole legal army to respond to litigation. Which brings us to…
  2. Save money. Yes, it costs money to contract with an IRO. You know what costs even more money? Fraud attorneys and settlements. During Fiscal Year 2016, the Federal Government won or negotiated over $2.5 billion in health care fraud judgments and settlements. Prevention is always the best cost savings.
  3. Save face. Anyone with internet access will know if you end up in a CIA via the OIG website, and that information will remain publicly available for years to come. Can your reputation sustain that level of tarnish?
  4. Improve your services. An IRO doesn’t just look for wrong, but can provide recommendations and useful teaching information for your staff to make your process better. An outside eye gives more than scrutiny, but clarity as well.
  5. OIG has already told you that they incorporate IROs into their process. Right on the OIG’s website, the utilization of IROs is listed as a common settlement outcome. OIG doesn’t pick the IRO, but they make them part of the process. If the OIG uses IROs to handle the aftermath, IROs make even more sense to prevent it from occurring in the first place.