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
• Length of Stay Management
• Documentation Consultation

Hospital Services

We help hospitals ensure that patients are classified in the appropriate level of care and therefore receive the correct payment for services provided to patients.

Our clinical team includes board-certified practicing physicians assisted by experienced RNs who understand the complex, criteria-based issues around Medicare and Medicaid reimbursement.

Our Physician Advisors are trained to review the medical records and apply medical judgment to the determination of inpatient vs. observation level of care. They are effective at communicating with the attending physicians and discerning the most appropriate site of service. Since they are physicians who know the challenges that go along with a busy medical practice they approach each review with an understanding that is evident to the attending physician. Their collaborative approach with attending physicians advances the goal to document appropriate level of care and therefore, assist the hospital in obtaining correct payment for the services rendered.

Also, as Recovery Audit Contractors (RACs) are set to impact hospitals across the country, a third party review and consultation can assist hospitals in providing documentation in the medical record to support the level of care that is billed. This process is a proactive approach and supports a strong compliance program and protects the hospital from both legal and financial difficulties.

For more information about Hospital Services, please contact us.