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Cancer Treatment Options: Independent Review Organizations (IROs)
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Added: 12/03/2004
Type: Summary
Viewed: 852 time(s)
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Cancer Treatment Options: Independent Review Organizations (IROs)
PORTLAND, OR December 3, 2004 --In 2004, nearly 1.4 million people will have been diagnosed with cancer, according to the American Cancer Society. The victims are fairly evenly divided, with males having a slight lead at 51 percent. The causes of cancer are seemingly too complicated to unravel, but the effects are unfortunately too obvious.
The rise in cancer diagnosis, combined with rapidly advancing medical research and technology, makes it increasingly difficult for patients, providers, claims payers and medical managers to distinguish between protocols for scientific experiments and the medically accepted protocols for treatment. While the two sound the same, they serve different ends. Experimental protocols are simply mechanisms for following scientific research that can be replicated and compared against an already standardized treatment to prove validity. This process may require several experiments and studies before treatment is sanctioned as a proven method that can be used on patients.
“Patients, along with their physicians, are always seeking the newest medical treatment advancements, especially when it comes to cancer,” said Dr. Skip Freedman, medical director at AllMed Healthcare Management, a leading Independent Review Organization (IRO). “What’s often hard to understand is that many of the experimental treatments for cancer being touted by the research community simply aren’t covered by insurance companies because they have not reached the medically proven stage.”
According to Dr. Freedman, the four major types of cancer treatments available today include surgery, radiation, chemotherapy and biologic therapies. New treatments, such as hormone therapies with Tamoxifen and transplant options involving bone marrow, are being added to these standard procedures on a regular basis. He added that burgeoning information on cancer treatment makes it hard for even the insurance companies to stay up-to-date on the latest advances.
To ensure patients are receiving the treatments they are entitled to and that payers are only paying for care that is medically proven and approved, it’s becoming imperative that payers have access to independent, Board-certified Oncologists and Hematologists as part of the claims approval and review process. Many payers are turning to Independent Review Organizations (IROs), such as AllMed, to help with this process. An IRO can provide access to the Oncology and Hematology specialists that understand the latest cancer treatment options and can help claims and medical managers stay abreast of which cancer treatments are sanctioned and should be added to patient care standards and which ones are still considered experimental. More information on the independent review services can be found on AllMed’s web site at http://www.allmedmd.com.
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 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.
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