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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

Compliments 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
%
of hospitals reported that the cost of
complying with insurer policies is increasing *
%
of appealed initial claim denials by
hospitals are ultimately overturned*

*American Hospital Association Survey: Commercial Health Insurance Practices that Delay Care, Increase Costs

Physicians discuss a medical case

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 Utilization 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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    Utilization Review Education

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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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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.

 

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