Our physicians have more than 15 years combined experience in utilization review and have performed tens of thousands of RAC (recovery audit contractor) reviews. We have succeeded in building collaborative relationships with treating physicians that is built on trust, expertise, and mutual respect.
We have a command of Medicare guidelines, including the 2-midnight rule, as well as the nuances of state Medicaid plans and commercial plans. Our physicians communicate with the treating physician on all status change recommendations.
We provide physician education regarding utilization management and serve on the utilization review committees at hospitals for which we provide physician advisor services.