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.
Compliance Solutions
The two most often requested Compliance Solutions are Medical Necessity Determinations and Two Midnight Rule Responsiveness. MedManagement's team members are also well-equipped to provide assistance with additional broader strategic and operational objectives.
Physician Advisor Services
MedManagement physician advisor services are available when you need them. Our physician advisors are trained and experienced to assist hospitals and physicians in examining documentation needed for compliance with health care 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.
Total Appeals Management
When an auditor (RAC, MAC, QIC, ZPIC, etc.) denies a payment to your facility as an overpayment, MedManagement physician advisors and lawyers are equipped to relieve the administrative burden of the appeals process for and/or with our clients. Our staff works diligently to write and submit clear, thorough appeals...
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.
Audit Preparedness and Response
Health care providers who invest in third party retrospective medical record reviews to identify trends in issues with process, protocols, coding and clinical documentation enhance their ability to catch any issues before they grow to a problematic level. MedManagement physician advisors and RNs are skilled at providing retrospective record reviews
