“a better way to serve hospitals …”
- Optimizing care
- Decreasing payer denials
- Maximizing revenue
AppriseMD adds MD level support to the daily processes of utilization review. We know the pace and constant need hospitals have for review, therefore, we offer services 365 days a year, 7 days a week and we guarantee a two-hour turn around time.
Our clinical and insurance expertise allows us to provide a higher level of quality customer service. AppriseMD offers more consistent reviews by a small team – including a licensed, board-certified physician with both clinical and health insurance experience – dedicated to each individual client. Every case we review is touched by at least two physicians.
We work within our client hospital IT system and workflow so there is no need to train hospital staff on new software.
Our increased level of internal quality controls ensures that reviews are accurate, understandable, actionable and customized to each client’s needs.
HIGHER QUALITY REVIEWS AT AGGRESSIVE PRICES
Our detailed monthly reports provide hospital executive teams with:
Monthly UM reports include complete data spreadsheets of initial reviews, re-reviews, approved and unapproved procedures as well as redirected services. Documentation is provided for total case reviews per day of the week for tracking purposes as well as a breakdown of insurance categories.
Reviews include counts of attempted and completed P2P details according to corresponding physician.
Based on feedback from hospital executives, we provide case updates such as determination for how to categorize patient class, designations for hospital/facility level of care appropriateness.
AppriseMD works to identify and document clinical issues that may be considered variant and/or of interest to hospitals such as same day or next day review of traditional Medicare cases for admission. Details are provided for non-approved P2P cases for insight into recommendations.
As reviews are conducted, our physicians provide evaluations in order to improve processes and offer continued recommendations or issues to better focus our efforts as well as our clients’ efforts to evolve with the changing healthcare environment.