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

RAC Audits

An audit from Recovery Audit Contractors (RACs) can make a huge impact on your hospital, clinic or practice. Even if you are in the right, if a Recovery Audit Contractor determines that your facility has been overpaid, RAC appeals are extremely time consuming and expensive. You can effectively prepare for and protect your facility in the case of an RAC audit with the help of MedManagement.

To prevent claims of overpayment during RAC audits, it’s essential that hospitals, clinics, inpatient rehab facilities and private practices be able to provide solid documentation to support the services and/or level of care that is billed. This not only ensures you receive the appropriate reimbursement for your services day in and day out, but can assist with audits from CMS.

MedManagement’s Physician Advisors are extensively trained to review medical records and determine the patient level of care, as well as provide the proper documentation that is looked at during RAC audits. Because they are physicians themselves, they understand the challenges of a busy hospital or medical practice, and approach each review with an understanding that is evident to the attending physician.

Because a large number of RAC take backs are a result of incorrect medical billing and coding, our Physician Advisors can also follow up with under-documented clinical procedures and ensure documentation and coding is compliant with the proper policies and procedures.

In the case of an RAC audit, we can provide you with the assistance needed to effectively handle RAC audits, file RAC appeals, and prevent future RAC take backs.

Our proactive approach to RAC audits supports a strong compliance program with solid clinical documentation to protect your hospital from both financial and legal difficulties. For more information on decreasing the risk of an RAC audit in your hospital, clinic or practice, please contact us today.