Services
Physician Advisory Services
Overview
Leveraging AGS Health’s team of skilled physicians and healthcare professionals to provide customized solutions to optimize clinical documentation, medical coding accuracy, and revenue integrity. Our physicians collaborate with your healthcare team ensuring accurate documentation reflecting patient conditions and care complexity. Additionally, we facilitate peer-to-peer reviews with insurance companies, enabling direct discussions between our physicians and the insurers' medical professionals. This collaborative approach promotes transparency, enhances communication, and fosters mutual understanding of complex cases.
SERVICES PROVIDED
Expert guidance supports optimal clinical and operations management to enhance quality, ensure regulatory compliance, and greater operational and financial efficiency. Services provided include:
- Integrating quality management, resource utilization, patient safety, regulatory compliance, and clinical documentation.
- Advice and support related to the medical necessity of services.
- Review of clinical records and documentation.
- Analysis of appeal and denial claims.
- Accurate documentation of patient conditions, symptoms, and treatments.
BENEFITS
Optimized Clinical Documentation and Coding Accuracy
Ensure clinical documentation accurately reflects patient conditions and the complexity of care provided to optimize revenue and maintain regulatory compliance.
Increased Revenue
Minimize financial losses through effective handling of clinical denials and appeals to ensure more efficient resolution and secure proper reimbursements.
Improved Communication and Transparency
Peer-to-peer reviews and direct discussions between healthcare professionals and insurance companies promote transparency, enhance communication, and foster a mutual understanding of complex cases.
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Additional Clinical Administrative Services to streamline your revenue cycle
Clinical Documentation Integrity Services
A combination of retrospective, prospective, and concurrent reviews of clinical documentation provides precision and specificity in clinical documentation tailored to inpatient and ambulatory settings.
Utilization Management Services
Provide appropriate, efficient, and cost-effective care consistent with current medical standards, preventing unnecessary procedures and optimizing treatment plans to enhance patient outcomes, streamline resource utilization, and drive healthcare excellence.
Clinical Denials and Appeals
Review denied claims to identify root causes, and craft compelling appeals supported by comprehensive clinical evidence to maximize revenue and minimize financial losses.
Clinical Prior Authorization Services
Secure clinical authorizations for complex medical cases, including prior authorizations (prospective) and concurrent authorizations, to ensure proper reimbursement and timely delivery of care aligned to payer contracts.
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