Effective utilization of resources is a key component to a hospital’s well-being. 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).

Status 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

Medical Necessity

Uniquely, we take patient status reviews to the next level by providing both medical necessity and documentation education directly to providers to support inpatient status assignment. We teach the use of action words to support the severity of illness (SI) and intensity of service (IS) of the hospital care provided.

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.

Contact us about our utilization services.

Click on the services below to learn about our comprehensive clinical documentation education and revenue cycle management solutions.