Targeted Solutions for:

• Physicians
• Hospitals & Hospital Executives
• Individual Practice Associations(IPAs)
• Self-Insured Employers
• Benefits Managers
• Wellness Managers
• Insurance Companies
• Inpatient Rehab Facilities

Physician Services Overview
Hospital Services Overview

Physician Advisory Services

Level of Care Consulting

Our clinical team reviews Medicare and Medicaid admissions and evaluates whether the patients are more appropriately classified as inpatients or as observation patients as defined by the Centers for Medicare and Medicaid Services (CMS). Since the level of care has an impact on what hospitals are paid it is important to verify that the medical record has adequate documentation to support the level of care that is submitted for payment. This process can improve your hospital's bottom line and at the same time support a strong compliance program.

Continued Stay Management

If your hospital has specific MS-DRGs for which the Length of Stay (LOS) is longer than expected, let our Physician Advisors assist you identifying barriers in treatment that could be affecting the LOS. The focus on throughput reduces LOS, improves satisfaction of the patients and increases capacity by freeing up beds in a timely manner. A proactive approach to discharge planning and the intervention by our Physician Advisors is a result oriented approach that can positively impact your bottom line.

Documentation Consultation

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. Our Physician Advisors serve as an excellent resource to your clinical excellence/case management staff to ensure that the medical record is a true reflection of the intensity of the services provided. Many times the information present in the medical record suggests that additional facts are present but not properly documented. Intervention by our Physician Advisors is an excellent way to improve documentation and therefore receive the appropriate reimbursement.

For more information, please contact us.