Physician Advisory Services

Our team of Physician Advisors is available to consult with attending physicians and staff on various aspects of a patient's stay that could impact receipt of the appropriate reimbursement. We have numerous practicing physicians on our staff assisted by experienced RNs who understand the complex issues that impact what hospitals are paid.

Services Include:

• Level of Care Consulting
• Continued Stay Management
• Documentation Consultation

Clinical Documentation

A goal of every hospital should be to document each patient's case so that the correct reimbursement is received for the specific services rendered. MedManagement’s Clinical Documentation Specialists serve as an excellent resource to your case management staff to ensure that clinical documentation on each patient’s medical record is a true reflection of the depth and intensity of the services provided.

Much of the factual information that must be incorporated into a health care decision-making process may not always be known to all team members, and many times the information present in a medical record suggests that additional facts are present but not properly documented. Team members often rely on documentation by physicians, but unfortunately such documentation can be very ambiguous, misstated or understated, non-specific, or simply missing. Furthermore, electronic medical records contain a vast amount of data and structural complexity, leading few physicians to actually review all information for accuracy.

Intervention by our Physician Advisors can help you develop a clinical documentation improvement program and ensure your hospital, clinic or private office receives the appropriate reimbursement for services.

A Clinical Documentation Specialist from MedManagement will:

• Review all components of medical records
• Follow up with undocumented or under-documented clinical procedures, querying medical staff for clarification of documentation with patients’ medical records
• Appropriately classify patients’ level of care as defined by the Centers for Medicare and Medicaid Services (CMS) and  commercial level of care screening criteria
• Ensure documentation is compliant with the associated insurance carrier’s procedures and guidelines to improve the accuracy of payment
• Oversee the creation and maintenance of patient records and medical histories
• Educate your medical billers and coders on proper policies and procedures to be followed when composing clinical documents.

The MedManagement staff constantly strives for excellence, and can provide you with clinical documentation solutions that work. For more information on clinical documentation assistance or other hospital solutions from MedManagement, please contact us.