Physician Advisor Services

for hospital utilization review 


Secondary Reviews, Short Stay Reviews & Payer Peer-to-Peer Reviews customized to your hospital size and need.

Full-Time Utilization Review Physician Advisor Services • Gap Coverage • Weekends, Nights & Holidays

Our physician advisors increase denial overturn rates, shorten revenue cycles and empower you to provide the most appropriate and effective clinical care.

AppriseMD adds value with

Peer-to-Peer Reviews
and ROI Tracking

Physician Advisor
Support

Access to Proprietary
Payer Database

Internal Audits of
100% of Cases

UR Education and Training
for Treatment Teams

Research, White Papers and
Case Studies

" Having been involved in hospital Utilization Review for over 10 years on the commercial insurance side and having worked as a surgeon, I understand the frustrations and challenges felt by hospitals in dealing with Utilization Review. I knew that there was a better way to support hospitals and created AppriseMD to meet hospital needs. "
FRANKLIN E BAUMANN MD

CEO & FOUNDER OF APPRISEMD 

APPRISEMD CASE STUDY: Chest pain, non-cardiac inpatient stay denial overturned

Chest pain is one of the most common ER diagnoses. For those patients who require hospital admission, getting the admission status correct and paid by the insurance company can be tricky.

Chest pain cases that are found to be due to causes other than frank acute coronary syndrome can often be difficult for inpatient level of care approval. We believe that these cases often involve significant hospital resources as well as significant treating physician concern. Clear and honest discussions about the admitting clinicians’ concerns, plan of care, and resources used can help get to the most appropriate level of care.

Read the full case study including clinical summary, denied inpatient stay and Peer-to-Peer discussion specifics.

DO YOU HAVE ISSUES WITH YOUR UTILIZATION REVIEWS?

AppriseMD's physician advisors know the problems and correct them.

ISSUE: "THE REVIEWS DON'T MAKE SENSE!"

Solution: AppriseMD creates customized reports with clear explanations for every case review.

ISSUE: "THE REVIEWS ARE NOT HELPFUL."

Solution: AppriseMD reports are actionable and our staff answers questions directly.

ISSUE: "WE NEVER GOT OUR REVIEWS!"

Solution: AppriseMD guarantees our turnaround time 24 hours a day.

ISSUE: "THE REVIEWS ARE INCONSISTENT!"

Solution: AppriseMD uses a consistent format for all our reports.

ISSUE: "THE REVIEWS ARE AUTOMATED!"

Solution: AppriseMD never automates any case review.

Our Expert Reviews Are Centered On:

  • Good Care

  • National Evidence-Based Guidelines

  • Timely Recommendations 24-7,
    365 Days a Year

  • Actionable Reports

All AppriseMD Reviews are conducted by
licensed and board certified physicians

With at least five years of clinical experience including inpatient care.
Confident representative pharmaceutical showing new medicines to a team of doctor and nurse in hospital. Mature specialist man showing bottle of pills and explaining drug dosage to a group of doctors.

Extensive managed care experience including payer and hospital UM.

Clinical conference to discuss every case.

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Every review is touched by at least two physicians.

No case review is automated or handled by a non-clinical expert.

Peer-to-Peer reviews handled for treating physicians.

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We review cases in a way that reflects our clinical experience.

Treating physicians given access to physician advisors.

Hospital Utilization | AppriseMD

Expert Medical Utilization Review

AppriseMD understands the frustrations and challenges felt by hospitals in dealing with Hospital Utilization Review.

We offer clinical expertise combined with insurance experience to support hospitals in a highly personalized process. We value transparency and honesty.

AppriseMD 707 Skokie Blvd #600, Northbrook, IL 60062, USA

Phone: (847) 849-1970
Email: info@AppriseMD.com

You may have found us by searching other common Hospital Utilization Categories:

Utilization Review Examples

Retrospective Utilization Review

Types of Utilization Review

Utilization Review Process Flowchart

Some other important pages:

Peer to Peer Reviews
Utilization Review Services

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