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Utilization Review Services

what sets us apart

We focus on hospital Utilization Review, which means you receive excellent reviews for every case.

We handle every aspect of your Utilization Review from patient admission to Peer-to-Peer reviews for denials.

Clinical expertise and preparation

  • Our physicians conduct a complete chart review of all clinical information including past admissions for every case we review.
  • Two physicians review every case, oftentimes three, via our proprietary
    Live Audit Review.

Clinical
review

  • We consider level of care or length of stay based on guidelines, clinical judgement, special circumstances, and payer status.
  • Our team holds a clinical conference to discuss each case.
  • The final determination is made by a small dedicated team led by a licensed board-certified physician with at least 5 years of inpatient experience as well as extensive managed care experience.
  • We partner with you to ensure the best outcome for your patients as well as your reimbursement. We identify clinical issues and future considerations for your staff with each review.
  • 100% of all cases are audited internally in order to maintain an environment of continuous learning and improvement.

Round the clock
services

  • 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 turnaround
  • During peak hours, a third physician will review your case. It is in the busiest times and when volumes are highest, that people are prone to mistakes. We created Live Audit Reviews for this reason.
  • We do not take holidays, providing services 24 hours a day, 7 days a week, 365 days a year.
  • Each review contains contact information. If your team has questions, the AppriseMD team is always easy to reach.

Our proprietary data base improves your review services

  • AppriseMD has developed a data base of all insurance payers case denials and approvals, disease processes, medical directors’ review standards and more.

Utilization Review | AppriseMD

Raising the bar for your after-hours utilization review service

AppriseMD offers Utilization Review for hospitals

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
Healthcare Information Research

Our Goals Are:

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Optimizing care

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Decreasing payer denials

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Maximizing revenue

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