Physician advisors at a fraction of the cost
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Fractional Physician Advisor
Trusted Physician Advisor Services
Fractional Physician Advisor provides experienced, dynamic, state licensed Physician Advisors to hospital systems at the fraction of the cost of a full time employee.
We seamlessly integrate into any hospital’s EMR and Utilization management system while leveraging the latest technologies.
Our Physician Advisors work closely with healthcare administrators, physicians, nurses, coders, and other healthcare professionals to implement strategies that improve patient care delivery, streamline operations, and maximize financial performance.
Physician Advisor Service Overview
Medical Necessity Reviews and Compliance
Physician advisors conduct second-level medical necessity reviews for patient cases that do not meet first-level screening criteria or do not have a documented expectation of length of stay. They also provide recommendations on inpatient admissions, outpatient and observation services, or cases not deemed appropriate for hospital-level services.
Physician Champion
As a physician champion, physician advisors consult with providers, particularly when difficult issues arise, and have critical conversations concerning resource utilization and medical necessity. There are unique challenges to each hospital and geography that our physician advisors are attune to being sensitive to.
Denial Management
Physician advisors conduct peer-to-peer discussions with the commercial payer medical director for cases that have been denied. Resolving medical necessity issues prior to a claim submission saves hospitals rework and maintains cash flow since fighting a denied claim can be a lengthy process and involve much rework.
Length of Stay Management
Physician Advisors assist case management with length of stay reviews and facilitate discussion with the attending physician in cases where there is no progression in the plan of care, an ambiguous plan of care, or where there may be an ability to arrange for a plan of care at an alternative level.
Education
Working side by side with case managers, physician advisors give direction to and training on patient process flow, and offer guidelines about level of care, length of stay, readmissions, and other utilization issues. They also serve as an educational resource for hospital staff regarding medical necessity and regulations.
Resources
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