ENGAGEMENT MODELS
Physician Advisor Service Options
Flexible, cost-effective engagement structures designed to meet your hospital's unique needs
Engagement Models in Detail
Per Case Model
Peer-to-Peer Review Support
Pay only for what you need — no retainer, no overhead.
Engagement Structure
- Billed per peer-to-peer review case completed
- No monthly minimums or long-term commitments
- Scalable to case volume — high or low
- Rapid onboarding — typically within 1–2 weeks
Core Services
- Peer-to-peer review calls with commercial payer medical directors
- Medical necessity documentation and clinical rationale support
- Denial prevention through proactive clinical review
- Real-time availability for urgent peer-to-peer requests
- Post-call summary and outcome tracking
Strategic Benefits
- Reduces denied claims and improves cash flow
- No fixed overhead — cost directly tied to utilization
- Access to board-certified, experienced physician advisors
- Ideal for hospitals with variable or unpredictable case volumes
Hourly Model
Peer-to-Peer Review Support
Predictable, flexible support billed by the hour.
Engagement Structure
- Billed at an agreed hourly rate
- Flexible scheduling — block hours or on-demand
- Monthly invoicing with detailed time logs
- Minimum hour commitments available for priority scheduling
Core Services
- Peer-to-peer review calls with payer medical directors
- Medical necessity and utilization management consultation
- Case management collaboration and clinical guidance
- Physician champion services for complex cases
- Length of stay management and discharge planning support
Strategic Benefits
- Transparent, predictable billing structure
- Broader scope of services within each engagement
- Builds ongoing relationship with a dedicated physician advisor
- Suitable for hospitals needing consistent, recurring support
Training Program
Physician Advisor Training & Development Program
Build internal physician advisor capacity within your organization.
Engagement Structure
- Structured curriculum delivered over 4–12 weeks
- One-on-one mentorship with a senior physician advisor
- Live case review sessions and real-world application
- Customized to your hospital's EMR and UM workflows
Core Services
- Medical necessity criteria training (InterQual, Milliman)
- Peer-to-peer review techniques and payer communication
- Utilization management principles and regulatory compliance
- Denial management strategies and appeal processes
- Preparation for ACPA-C or CHCQM-PHYDV certification
Strategic Benefits
- Develops long-term internal physician advisor expertise
- Reduces reliance on external advisors over time
- Improves hospital-wide utilization management culture
- Supports physician career development and retention
Ready to Get Started?
Contact us to discuss which engagement model best fits your hospital's needs. We offer a complimentary consultation to assess your current utilization management challenges.