An Alternative Approach to the 800 lb. Gorilla

Are you getting the attention you deserve?  Are your reporting needs meeting your expectations?  Are your turnaround times exceeeding your established standards?  Are you receiving feedback  leading to performance improvement?

AppealMasters and Resonant Physician Advisory have created a collaborative partnership to provide hospitals with an end-to-end  solution – Concurrent Review  and Retrospective Appeals expertise.

 

Resonant Physician Advisory Services delivers a full spectrum of secondary case review and audit defense services.

Resonant’s services are customized to meet each hospital’s unique needs for physician advisor case review. Our cost-effective service drives cost reductions per case down by 25-35%, compared to average industry rates. Resonant emphasizes the importance of accurate patient status analysis to provide robust case determinations.

Gain the advantage of targeted, interactive feedback and education to improve the UR process, enhance physician alignment, boost effectiveness, and meet your strategic goals.

Hospital Expertise – Our physician advisors are experts in the application of rules and regulations related to observation and inpatient status.  As a result, Resonant can provide accurate, concurrent/secondary physician review for observation service cases and inpatient admissions utilizing evidence-based clinical decision support criteria.

Flexible and 24/7 Support – Real-time medical necessity and clinical compliance management solutions are available. Resonant coordinates reviews with your hospital’s medical staff leadership, attending physicians, and care management team accordingly to your timeline.

End-to-End Assistance –  Physician advisors conduct an analysis of each case and report findings back to you – usually within 60 minutes. AppealMasters provides the full-spectrum support of the appeal process from initial denial through ALJ/External review. We also provide services to review commercial payor clinical case denials. Our goal is to “get it right the first time” and minimize the probability of an audit, while enhancing case “win-ability”.

Accountable Results – Resonant’s proactive, ethical, compliance-based approach leads to better coordination of care. Our metrics and analytic-based platform provide key data on trends and performance as well as feedback to ensure consistent documentation and targeted education opportunities.

Cost-Effective – Save 25-35% compared to industry standard rates. Contracts are based on no cause-outs and without monthly case minimums.

Process Driven – Actionable feedback provides continued performance improvement. Efficient turn-around optimizes your care management team’s efficiency.