Denial Management
Physician Advisor Services
to Optimize Reimbursement
Achieving excellence in utilization review to improve revenue cycle.
Optimize reimbursement, reduce denials and shorten your revenue cycle with our team of licensed, board-certified denial management physician advisors experienced in payer and clinical settings.
Improving Revenue & Patient Care Through Utilization Review Excellence
We focus on denial prevention to augment revenue integrity, allowing hospitals to provide higher quality care.
Timely Reviews
Timely ReviewsCompliments existing workflow for a seamless adoption
Reimbursement Resolution
Optimize reimbursement through physician advisory
Payer and Clinical Experience
Licensed & board-certified denial management physician advisors
Customized Reporting
Physician-driven documentation aimed at identifying denial root causes
Physician Owned & Operated with Physician Advisor Solutions that:
- Increase reimbursement revenue through timely utilization review turnaround times
- Reduce denials with medical necessity determinations facilitated by physicians with payer expertise
- Reinforce revenue integrity with physician-directed discernment and healthcare analytics
- Improve quality of care and length of stay with physicians skilled in exercising complex medical judgement
- Enhance revenue cycle through excellence in utilization review
- Increase compliance with a unified approached to utilization and denial management
- Protect your revenue cycle by aligning care status to mitigate denials with physician advisor experts
Ensure appropriate level of care with our revenue integrity physician advisory solutions and optimize your revenue cycle.
Hospital Utilization Management Services
Second Level Case Reviews
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Payer Peer-to-Peer Reconsideration
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Medicare Short Stay Chart Audit
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Discharge Reviews
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Internal Peer-to-Peer Conference
Appeal Reviews
Physician Advisory
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Remote Support
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Full-Time Support
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Night, Weekend & Holiday Support
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Interim Support
More from AppriseMD
Case Study: Medical Necessity Behind Short Stay is Key
CLINICAL SUMMARY: Medical Necessity Behind Short Stay is Key This case involves a one-day inpatient denial for a 30-year-old patient treated for acute pancreatitis. With abdominal pain and nausea, the patient went to the Emergency Department where he was found to have upper abdominal pain and tenderness, a lipase of […]
Read MoreHealthcare Insights
Read more about the balance between care and cost in our latest white paper.
Blog
HHS OIG Report Shows Code Adjustments May Indicate Denials
In a report released March 2 by OIG, investigators found “that most 2019 MA (Medicare Advantage) encounter records contained at least one adjustment code and […]