Providing the best outcome for patients through UR

“The Hippocratic Oath is one of the oldest binding documents in history. Written in antiquity, its principles are held sacred by doctors to this day: treat the sick to the best of one’s ability, preserve patient privacy, teach the secrets of medicine to the next generation…” 1

As a physician-owned company in which board-certified physicians carry out our mission to serve hospitals in delivering expert utilization review services, AppriseMD’s medical team members have all taken the Hippocratic Oath and sworn to put patients’ health first, to provide medical reviews with “conscience and dignity”2 and to work to provide the best outcome for patients. We pay special attention to what is in the best interest of the patient and the hospitals for whom we work. In practicing utilization review, we advise on the most appropriate and safe level of care and act as a go-between for physicians and insurance providers. Being a physician-owned organization and having a team of physicians means we care about treatment of patients and share in a hospital’s commitment to patients. But in today’s world, treatment not only involves medicine but costs – sometimes significant costs to both the patient and the hospital.

From the moment a patient steps foot into a hospital, a utilization review team is working behind the scenes to help treating physicians coordinate care with what payers (health insurance companies or Medicaid/Medicare) will pay for treatment. It is a complicated layer that we aim to help ease for physicians on the front lines. While we never meet the patients whose cases we review, our clinical experience gives us the ability to see the treating side of the equation while working to reconcile that with the payment side of medicine. When the Hippocratic Oath was written in 5th Century BC and even when the modern version was re-written by Louis Lasagna in 1964, doctors were not working within the complex healthcare system operating today in the United States, especially when it comes to intricacies of healthcare insurance. Physicians waiting for you in the ER or the OR are highly trained, skilled practitioners in their fields of medicine. But most are not highly trained in healthcare insurance. Our mission is to bring the skilled understanding of healthcare insurance requirements to the treatment of patients in the hospitals we serve and, by doing so, helping doctors fulfill the oath they took. It is in forming this team with the hospitals we serve, that we support their physicians to all treat patients to the best of their ability and to “… remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.”3

 

  1. February 2009 “The Hippocratic Oath Today,” Peter Tyson, NOVA https://www.pbs.org/wgbh/nova/doctors/oath.html
  2. The Physician’s Oath, World Medical Association (Geneva, Switz.) Health Sciences Library McMaster University https://hslmcmaster.libguides.com/c.php?g=306726&p=2044095#:~:text=Hippocratic%20Oath%20%2D%20Modern%20Version&text=I%20swear%20to%20fulfill%2C%20to,those%20who%20are%20to%20follow.
  3. Hippocratic Oath, Modern Version, written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University
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