C.F.R. provides audits and assessments of case management level of service assignments for inpatient versus observation status. Assessment of the accuracy of level of service assignments along with the assessment of the quality of the clinical documentation available to support inpatient or observation assignment is provided with analysis and recommendations.
Our Board Certified Physician Advisors merge clinical and regulatory expertise to provide Medical Necessity determinations for concurrent reviews, peer to peer appeals, post-discharge audits, and denial management.
With expertise in Utilization Review, documentation, coding, inpatient and outpatient risk adjustment, and quality metrics, our physician staff a resource in closing the loop with departmental and individual topic-focused education.
Appropriate align your compliance department and your revenue department for optimal results with appropriate level of care assignments. Address the aggressive commercial payer denials with experienced clinicians from optimal clinician documentation, to reliable successful payer peer to peer appeals, and denial management.
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