Denial Management
Physician Advisor Services

to Optimize Reimbursement

A unique approach focused on preventing denials and determining root causes.

Optimize reimbursement, reduce denials and shorten your revenue cycle with our team of licensed, board-certified physician advisors experienced in payer and clinical settings.

Improving Patient Care Through UR

We focus on denial prevention and appeal management so hospitals
can focus on caring for patients.

Immediate ROI

No software glitches & no annual maintenance fees

Reimbursement Resolution

Compliments existing workflow allowing for a seamless adoption

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-Driven 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 patient safety and length of stay with physicians skilled in exercising complex medical judgement
of hospitals never appeal denials
of all hospital denials are preventable
to 65% of claim denials are not resubmitted
of claims get denied or ignored on initial submission

Ensure appropriate level of care with our revenue integrity physician advisory solutions and optimize your revenue cycle.

Hospital Utilization Management Services

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    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

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    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

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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 […]

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Optimize patient care, reduce denials and maximize reimbursement through our unique approach to achieving excellence in utilization review.

Discuss your hospital's denial prevention and appeal management needs with our team.


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