Physician Advisor Services

for hospital utilization review 


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

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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

PHYSICIAN ADVISOR SERVICES
PEER-TO-PEER REVIEWS
FREQUENTLY ASKED QUESTIONS

" 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 

Healthcare professionals during a meeting at the hospital - High angle view
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Dealing with Denials

90% of inpatient denials are preventable. So why do they keep happening?

A compendium of research compiled by

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New from AppriseMD

AppriseMD partners with UnityPoint Health to improve physician advisor services for utilization management

CHICAGO, IL – AppriseMD announced a new partnership today with UnityPoint Health to provide utilization management physician advisor services to its entire hospital system of 20 regional hospitals across Iowa, Illinois and Wisconsin.

Previously, AppriseMD supported the UnityPoint Health Quad Cities hospital utilization management departments. The new partnership expands physician advisor services throughout the UnityPoint Health enterprise, bringing a new level of customer service and expertise to its utilization management teams.

READ MORE

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.

Peer To Peer Review for Hospital Cases

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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New UHC Hospital Services Observation and Inpatient Policy takes effect Dec. 1, 2022

UnitedHealthcare’s Observation Utilization Review Guide is sunsetting and will be replaced by the new Hospital Services: Observation and Inpatient Policy1. ...
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Without proper documentation, inpatient denials are often upheld

Peer-to-peer discussions between hospital physicians – or their physician advisors – and the insurance company’s medical director can often overturn ...
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Determining observation stay guidelines

Which guidelines should hospitals follow for an observation stay?

Both national evidence-based guidelines and insurance company guidelines factor into level of care determination.   When it comes to determining ...
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