Compliant Level of Care & Denials Management that Protect Revenue

Our compliant level of care status determinations are performed by experienced physician advisors and include medical necessity education to prevent future denials. Overwhelmed with denials? We can also help manage payor denials to recover revenue. Our physician advisors are experienced in working with all major commercial payors and apply best practices to succeed on appeal.

Gap coverage nights and weekends | 60-minute average turnaround

NO MINIMUM CASES REQUIRED.

What is improper level of care costing you?

Insurance companies have a team of people working to protect their revenue, and so should you. Improper level of care may be costing your organization thousands of dollars per admission. Our expert physician advisors base all level of care determinations on sound medical necessity criteria with effective documentation to ensure accurate reimbursement for providing quality, inpatient care.

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

Gap coverage: pay only for what you need

Our physician advisors are experienced in conducting patient status reviews for determining appropriate level of care for health systems nationwide. For physician advisor gap coverage, pay only for what you need, when you need it, with no minimums required. Net immediate revenue ROI, plus use our proprietary analytics program to get concurrent analytics to optimize your healthcare system’s revenue cycle.

Ensure cases reviews are based on sound medical judgement with our 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
  • Physician advisor support, including gap coverage on nights, weekends and holidays with a 60-minute average turnaround
  • Educational approach that includes medical necessity and documentation education
  • Denials management, including peer-to-peer and appeals support
hospital staff reviewing a chart
hospital workers in a hospital setting

Our Results

Our clients see a direct, positive impact on revenue with our compliant level of care support and denials management services by ensuring appropriate reimbursement for providing high-quality inpatient care. Contact us and we can begin reviewing your cases in as quickly as one business day. See our results by the numbers below.

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