Physician Advisor Gap Coverage
Aerolib Healthcare Solutions provides Physician Advisor Gap coverage for weekends, holidays and after hours coverage for Physician Advisors to develop the next generation hybrid model of Physician Advisor program. We help with education to Physicians, Case managers, Utilization Review personnel and nursing staff which is based on Aerolib`s successful education methodology of Disease Specific Documentation Improvement.
Our determination letters include
- Case Summary: Includes chief complaint and summary of clinical events detailing medical necessity and severity of illness
- Bedding status recommendation: Inpatient or Observation
- Audit Risk Score: Calculated using proprietary Aerolib Analytics, this gives an estimate of the risk of an audit
- At Risk Reimbursement: based on DRG, LOS and billing submissions from existing hospital data and Medicare payments for region
- Interventions to decrease Audit Risk Score
Physician Advisor Services
Aerolib Services include:
- Level of care recommendations
- Retrospective reviews
- Readmission reviews resulting from Audits, Denials or investigation
- Peer to Peers, Denials, Appeals, Notice of Intent to Deny or Pre-denial Discussions
- Regulatory audits
- Preadmission outpatient case reviews
- DRG Validation reviews
- Chart reviews for Revenue Integrity
- Peer Review for medical necessity and value driven care
- Clinical and Medical Policy evaluation
Definition of Aerolib Physician Services
– Level of care recommendation- At the request of the client, an Aerolib physician will review the record of a patient who is currently in a client hospital bed for less than 2 midnights (≤2MN) at the time of referral. An Aerolib physician will review the available medical record and make a level of care recommendation.
– Continued stay review – At the request of the client, an Aerolib physician reviews the record of a patient who is currently occupying a hospital bed for greater than 2 midnights (>2 MN)
