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Compliant Level of Care that Prevents Denials

Effective utilization of resources is more important now during the COVID-19 pandemic than ever, as hospitals are experiencing shortages in utilization review and care coordination. Our physician advisors conduct patient status reviews for determining appropriate level of care based on medical necessity, with concurrent analytics that provide actionable insight. 

Gap coverage nights and weekends | 60-minute average turnaround

Prevent denials before they occur

Effective utilization of resources is a key component to a hospital’s throughput.

Keeping up with case management can be challenging and may present opportunities for denials. Our physician advisors act as liaisons between hospital case management departments and attending physicians to help render opinions regarding utilization of resources, continued stay and admission status based on sound medical judgment.

We promote physician efficiency and strengthen communication between providers and case management with the goal to make hospitals more efficient and decrease length of stay (LOS).

healthcare workers reviewing a paper
medical doctor with a pile of charts on his desk

Compliant Level of Care Assignment

Determining the correct status assignment can be a cumbersome task. Many health systems are looking for cost-effective ways to optimize status determination to allow their internal physician advisors to focus on more global projects that increase efficiency. Our physician advisors conduct patient status reviews for determining appropriate level of care for health systems nationwide.

You may need us if…

  • Your current claim status is increasingly denied.
  • You’re tired of ineffective EHR.
  • You’re partnered with the world’s largest insurance company.
  • Your volume of peer-to-peer reviews is growing.

Replace your ineffective status assignment with a high-quality physician-based solution!

  • Concurrent (in-house) case reviews
  • Retrospective (post discharge) case reviews
  • On-site physician advisor training customized to the client’s needs
  • Gap coverage nights and weekends with a 60-minute average turnaround
  • Educational approach that includes medical necessity and documentation education
  • Inpatient or observation
hospital staff reviewing a chart
hospital workers in a hospital setting

Extended Stay Reviews

We provide concurrent admission and continued stay reviews, acting as a liaison between the hospital case management department and physicians, to encourage efficient utilization of resources to optimize the length of stay.

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