Clinical Reviews/Utilization reviews services
We prepare concise clinical reviews of the patients by viewing EMR and including the abnormal findings of the patient to be sent to the facility for approval from converting OBS and ER patients to Inpatient by justifying medical necessity.
We analyze potential admissions as per MCG and Change health care (InterQual) guidelines.
We coordinate with the facility coordinators in completing the tasks and fax the documents & reviews to the facilities within TAT.
We make sure that patient’s EMR management is done by implying the HIPAA compliance act.
We give 24/7 coverage to the Hospitals we work for to ensure timely clinical reviews are done for each and every patient who comes in ER.
Our Services
We serve all your needs under one roof
Eligibility and Benefits Verification
Eligibility verification is the process of verifying a patient;s insurance in terms of Validity (Active/Inactive), coverage of benefits
Referrals and Prior Authorization
Our team is knowledgeable in each and every aspect of health insurance, healthcare terminologies and medical/surgical procedures, our verification specialists work with payers as well as patients
Provider Enrollment and Credentialing
Insurance credentialing services help to enhance the entire process of revenue cycle management. An efficient and streamlined workflow will lead to lesser claim denials and an improved patient experience.
Clinical/Utilization Reviews
We prepare concise clinical reviews of the patients by viewing EMR and including the abnormal findings of the patient to be sent to the facility for approval from converting OBS and ER patients to Inpatient
Medical Records Abstraction
Medical Record Abstraction services deliver fast, accurate abstraction of clinical data components that document the provision of compliant care for HEDIS® reporting, and other quality measurement needs. This service creates a base medical record for a patient by going through all the patient’s old medical charts.
Remote scribing
“Spend More Quality Time With Patients, Not Entering Data” Electronicmedical records (EMRs) improve efficiency and make medical information easier to share with patients, providers, and payors. However, all of that data entry takes time away from patients and adds time to a provider’s busy schedule. Our highly trained, remote medical scribes can help.