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
Optimize patient care, reduce denials and maximize reimbursement through our unique approach to achieving excellence in utilization management.
Discuss your hospital’s utilization and denial management needs with our team.
AppriseMD is Physician Owned & Operated with
Utilization Review 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
complying with insurer policies is increasing *
hospitals are ultimately overturned*
*American Hospital Association Survey: Commercial Health Insurance Practices that Delay Care, Increase Costs
Ensure appropriate level of care with our revenue integrity physician advisory solutions and optimize your revenue cycle.
Hospital Utilization Management Services
Second-Level Utilization Reviews
Payer Peer-to-Peer Reconsideration
Medicare Short Stay Chart Audit
Discharge Reviews
Utilization Review Education
Appeal Reviews
Physician Advisory
Remote Support
Full-Time Support
Night, Weekend & Holiday Support
Interim Support
More from AppriseMD
Case Study: AMA Inpatient Denial Overturned
CLINICAL SUMMARY: A 75-year-old male arrived at the Emergency Department with fevers, body aches, shortness of breath and chills. The patient had a medical history of Type 2 diabetes, hypertension and chronic urinary retention for which he self-catheterized. Additionally, the patient had diabetic peripheral neuropathy being treated with gabapentin, and […]
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Read our new paper
Addressing Healthcare Reimbursement
A Focus on Denial Management and Medical Necessity
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Hospitals should file a complaint when the Medicare Advantage (MA) plans do not follow the Two-Midnight rule
An American College of Physician Advisors’ (ACPA) recent report concurs with earlier data from AppriseMD that many Medicare Advantage Organizations (MAOs) are not complying with […]