Setting the standard for quality physician advisor services.
MedManagement, LLC was founded in 1995 to provide clinical and financial management tools and resources to providers. With a keen eye toward the ever-changing healthcare regulatory landscape, we identify the needs of health care providers and respond with services and education as a valuable partner. Our current services and solutions provide expertise, consulting, education, and process management for hospitals, hospital systems, accountable care organizations, commercial health insurance companies, law firms and physician practices. Physician Advisor Services, Physician Advisor Training, Two Midnight Interpretation & Compliance, RAC Appeals, MAC Appeals, Probe and Educate Audit Response, IRO Services and other Compliance Solutions are at the heart of MedManagement’s service offering.
Total Appeals Management
Available 24/7, our physician advisors are trained and experienced in assisting attending physicians in making patient status decisions and ensuring complete documentation needed to be in compliance with healthcare law and CMS rules, regulations, and guidance.
Case Management & First Line Utilization Review Support
MedManagement RNs are accessible 24/7 to support hospital and case management staff with first line medical necessity screening. Often, hospitals leverage our 24/7 availability to fill gaps in on-site case management staffing during night and weekend time frames.
Audit Preparedness & Response
Our physician advisors are trained to review medical records in real time to assist attending physicians in making compliant patient status decisions. The Two Midnight Rule includes both clinical and administrative requirements. MedManagement staff have the expertise to support hospitals in both realms.
Client Education
In order to support our clients in achieving their quality of care and compliance goals, we listen. MedManagement is committed to providing ongoing training and other forms of education to clients on a regular basis.
Independent Review Organization (IRO) Services
Healthcare providers who are committed to adherence with a Corporate Integrity Program will find MedManagement, LLC to be a valuable partner in this important strategy. MedManagement provides independent review of medical necessity requirements, which affords healthcare providers the assurance of thoroughness and quality.
ACO and IPA Services
Our leadership has extensive experience in developing and managing an effective ACO; structure, systems, culture, clinical and financial integration, outcomes orientation, accountability mechanisms and performance measurements.
Medicare Conditional Payment Recovery and Set Aside Services
MedManagement is always searching for new ways to support participants in the health care system to operate within the law as well as in compliance with CMS rules & regulations.
Compliance Solutions
MedManagement offers review services to support internal audits and assist with protocol development and monitoring to facilitate compliance. Flexibility and client-focus drive our Compliance Solutions with every solution designed specifically for each client's unique needs. Requested most are Medical Necessity / Patient Status and Two Midnight Responsiveness analysis and recommendations.
