Denial Management
Physician Advisor Solutions

Excellent utilization review services that improve revenue cycle and reimbursement.

AppriseMD Founder and CEO Franklin Baumann, MD

"We have an increased level of internal quality controls to ensure that reviews are accurate, understandable, actionable and customized to each hospital's needs."

- Founder and CEO Franklin Baumann, MD

Improving revenue cycle management and patient care through utilization review excellence

Optimize reimbursement, reduce denials and shorten your revenue cycle with our team of licensed, board-certified denial management physician advisors. We focus on denial prevention to augment revenue integrity, allowing hospitals to provide higher quality care:

  • Boost reimbursement revenue through timely utilization management aimed at minimizing denials.
  • Reduce denials and increase compliance with a unified utilization management approach to medical necessity determinations.
  • Maximize revenue cycle with utilization management expertise facilitated by physicians with payer and hospital experience.
  • Overturn denials and hold payers accountable with a team dedicated to reinforcing revenue integrity and resolving reimbursement.

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.

 

weekend gap analysis graphic

Ensuring appropriate level of care placement every day is essential for revenue optimization.

After-hours physician advisor solutions:

  • Improve patient flow
  • Reduce unnecessary hospitalizations
  • Ensure regulatory compliance
  • Optimize reimbursement and revenue cycle
  • Maximize quality outcomes
  • Supplement existing team to reduce burnout

Achieve excellence in utilization review by increasing your revenue and shortening your revenue cycle with accurate medical necessity determinations with after-hours coverage on nights, weekends and holidays.

AppriseMD is physician owned and operated with utilization review physician advisory solutions that:

  • Align care status level with medical necessity determinations facilitated by physicians with payer experience.
  • 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 judgment.
  • Protect your revenue cycle by aligning care status to mitigate denials with physician advisor experts.
  • Identify the root cause of denials through customized reporting.
  • Enrich your financial and clinical outcomes with denial management and US-based physician experts.
  • Promote compliance to strengthen reputation.
  • Control expenses with no maintenance fees and software installation.
  • Strengthen patient safety with physicians to support overflow patient status determinations.
%
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

AppriseMD logo mark in brand orange.

Quotation marksPartnering with AppriseMD for our utilization management needs has been a great decision. Their team is very easy to work with, they are responsive to our needs, and have formed a true partnership with us as we work through system realignment for our utilization management functions.”

Angela Wilson Reis, BSN, RN

Director of Utilization Management for UnityPoint Health

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

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