Insurer cases referred to an independent review organization (IRO) are assigned to certified IROs by rotation. Carrier instructions - How to request an IRO assignment and submit results (PDF, 1.3MB)IRO review login See alsoCertifying as an independent review organization (IRO)Independent review of health care disputes and IROs - RCW 48.43.535Need more help?Call us at 206-464-6833Contact us about the independent review process