Medicare vs. Medicare Advantage
Understanding the key differences between Medicare and Medicare Advantage plans and how they impact hospital reimbursement and utilization management.
Read moreTRUSTED PHYSICIAN ADVISOR SERVICES
Physician Advisors at a Fraction of the Cost
Fractional Physician Advisor provides experienced, dynamic, state licensed Physician Advisors to hospital systems at the fraction of the cost of a full time employee. We seamlessly integrate into any hospital's EMR and Utilization management system while leveraging the latest technologies.
Physician Advisor Service Overview
Medical Necessity Reviews and Compliance
Physician advisors conduct second-level medical necessity reviews for patient cases that do not meet first-level screening criteria or do not have a documented expectation of length of stay. They also provide recommendations on inpatient admissions, outpatient and observation services, or cases not deemed appropriate for hospital-level services.
Read morePhysician Champion
As a physician champion, physician advisors consult with providers, particularly when difficult issues arise, and have critical conversations concerning resource utilization and medical necessity. There are unique challenges to each hospital and geography that our physician advisors are attune to being sensitive to.
Read moreDenial Management
Physician advisors conduct peer-to-peer discussions with the commercial payer medical director for cases that have been denied. Resolving medical necessity issues prior to a claim submission saves hospitals rework and maintains cash flow since fighting a denied claim can be a lengthy process and involve much rework.
Read moreLength of Stay Management
Physician Advisors assist case management with length of stay reviews and facilitate discussion with the attending physician in cases where there is no progression in the plan of care, an ambiguous plan of care, or where there may be an ability to arrange for a plan of care at an alternative level.
Read moreEducation
Working side by side with case managers, physician advisors give direction to and training on patient process flow, and offer guidelines about level of care, length of stay, readmissions, and other utilization issues. They also serve as an educational resource for hospital staff regarding medical necessity and regulations.
Read more
"The right physician advisor doesn't just reduce denials — they transform the way your clinical and revenue teams work together."
— Fractional Physician Advisor
Engagement Models
Flexible Service Options for Every Hospital
Whether you need per-case reviews, hourly consulting, or a comprehensive training program, we offer engagement models designed to fit your hospital's budget and workflow.
View Service OptionsPer Case
Pay only for the cases reviewed — ideal for variable utilization needs.
Hourly
Flexible hourly consulting for targeted projects and advisory support.
Training Program
Structured education programs for your clinical and administrative staff.
Resources
DRG Payment Information
What is a DRG Payment? A Diagnosis-Related Group (DRG) is a patient classification system that standardizes prospective payment to hospitals and encourages cost containment.
Read more
How to Become a Physician Advisor
A guide to the credentials, training, and career path for physicians interested in transitioning into a physician advisor role within hospital systems.
Read more