treatment or service.
An organization (sometimes called an Independent Review Entity or IRE) that has no connection to a Medicare health plan or Medicare Prescription Drug Plan. Medicare contracts with the IRE to review a case if a beneficiary appeals their plan’s payment or coverage decision or if the plan doesn’t make a timely appeals decision.
Independent reviewers ensure fair adjudication of appeals, providing beneficiaries with an unbiased evaluation of their cases. Understanding their role empowers individuals to navigate the appeals process effectively, ensuring equitable treatment.
Curious to learn more about the appeals process and the role of independent reviewers? Download our informative e-book for valuable insights and guidance on navigating Medicare appeals successfully.