Physician Advisory

Our Physician Advisory Solutions help physicians and case managers navigate the regulatory environment to ensure an increase in billing compliance and a reduction in clinical denials.

Unlock root cause of denials.

Revenue cycle teams face shrinking margins and an increasingly challenging reimbursement climate such that even a small percentage of denials can significantly impact financial performance. We can drive revenue optimization in the following areas:

Remote Utilization Reviews

Utilization review specialists (RNs) provide the initial, concurrent or retrospective medical record reviews to confirm the appropriate level of care.

Admission Status Review

Licensed physicians conduct level of care reviews supported by medical literature and in accordance with Medicare rules.

Focused Chart Audits

Physicians perform retrospective audits based on clinical documentation and regulatory guidelines to make recommendations for admission status, medical necessity, physician documentation and length of stay.

Payer Peer-to-Peer

Experienced physician advisors work actively with payer medical directors to overturn concurrent commercial denials.

Appeals and Denials Management

A multi-disciplinary team manages the appeal process and provides denial root-cause analysis to help prevent future occurrences.

Customized Education Programs

Physicians design and lead customized training programs for case management, physician advisors and attending physicians.

Talk to our insurance experts

Speak with insurance experts and ask questions before finalizing your plans or if you want help regarding our services. Our dedicated staff is more than happy to call and guide you.