AMS physicians will retrospectively review case documentation and give Independent Medical Reviews for clinical issues. Upon evaluation, our physician consulting can pinpoint wasted costs and care. This can address medical necessity concerns, experimental/investigational issues, quality of care, accidental death assessments, Medicare re-pricing and length of stay disputes. This program is a low-risk way to look into the clinical past of a claim, by identifying any inaccuracies or potential problems before it is pushed down the line. Our physician consulting service has more than 700 physicians who are accredited and currently practicing. The expertise of these physicians range across the medical spectrum and we can find the right doctor with the right experience to objectively look at the entire claim.
Through Independent Medical Reviews, AMS physicians can see if certain medical services were needed or if a procedure was experimental. Pinpointing these procedures can cut costs and clear up unneeded overhead. Other reviews can figure out the quality of care patients receive or assess possible accidental death cases. Our physician consulting can ask the tough questions that you may know to as or may not know to ask. Was the care necessary? Was an extended hospital stay needed? Was the procedure a necessity? We make sure that the care was appropriate through the conditions of the problem. We also make ask the questions you want to be answered. Do you have thoughts on a certain claim, but need confirmation? Do you want us to ask other tough questions? That is something our Independent Medical Reviews service provides. We also look at experimental practices or practices that are not FDA approved. Reviewing the case will also decipher coding and the overall quality of the care. All of these issues are addressed to detect that the claim is either accurate or erroneous.
Our Independent Medical Reviews include an executive summary with clinical conclusions and rationale as well as a detailed clinical summary of each hospital day reviewed. This level of thoroughness can be easily overseen, without the help of AMS expert physician consulting. This service not only helps our clients but it is invaluable in making the healthcare world more efficient and responsible.
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