We drive excellence in utilization review through physician-driven solutions designed to enhance your revenue cycle.
Our focus on denial mitigation helps our clients optimize revenue so they can provide higher quality care.
Translating Data into Reimbursement
Our data driven insights uncover strategies to help hospitals and health systems achieve optimal financial results. Quarterly meetings are scheduled with our clients to ensure they understand the data we capture, which provides actionable insights for optimizing revenue cycle. Opportunities to positively impact reimbursement are identified through the data, some of which include root cause identification, missed reimbursement opportunities, and extended observation stays.
Quarterly Reporting Example
All of our reviews include a physician accessing the electronic medical record so he or she can capture the information that is needed for one of our physician advisors to provide a recommendation on utilization as it relates to medical necessity, level of care, discharge, or even the information needed for overturning a denial or conducting an audit. All reports are customized to the client needs, and each report includes some standard data, some of which is illustrated in our quarterly reporting example.