Today’s hospitals and health systems require physicians’ clinical expertise tied to in-depth knowledge of documentation best practices, length of stay management, quality, contracting, billing, and compliance, among other disciplines. Hospitals and health systems have invested significantly in building internal Physician Advisor teams to address these needs.
However, internal Physician Advisors may lack the tools, operational expertise, or content necessary to solve today’s hospitals’ complex and ever-changing issues. That is where Versalus Health can help.
Versalus Health offers your organization Physician Advisor solutions to help with:
Utilization Management (UM) and Utilization Review
Clinical Documentation Integrity (CDI)
Physician Advisor Education
Physician Advisor Staffing
Versalus Health’s Physician Advisors are flexible, including case reviews, appeals, or dedicated Physician Advisor staffing customizable to your needs. You can scale up or down at any time.
If you already have a Physician Advisor team, Versalus Health upgrades your team by providing the visibility to program performance and targeted expertise they need. Our Physician Advisor solution allows hospital Physician Advisor teams to prioritize cases that have a high impact on compliance and revenue integrity while monitoring all outcomes to ensure optimal performance.
The Versalus Approach to Physician Advisor Services
Versalus Health employs a multi-step process to help hospitals and health systems choose the type of support they need. These steps include:
Assess Organizational Needs
A Physician Advisor program is not one-size-fits-all. We work with a wide range of facilities, all with different strengths and challenges. Before we recommend any changes, we assess your current Physician Advisor program needs. We analyze your data to determine where your organization’s performance could be further optimized. We evaluate your processes across the clinical revenue cycle, which includes UM, CDI, and compliance needs.
The Versalus Health data analysis and process evaluation go beyond patient status. It includes all the other elements that impact the clinical revenue cycle, like the quality of care issues, length of stay issues, commercial payer performance, diagnosis-related group (DRG), and coding integrity, to name just a few. We meet with your team to assess whether the current Physician Advisor structure is appropriate for your organization’s needs and how the patient status, documentation, and appeals processes are performing. Once that assessment is complete, we discuss our findings with you and begin the process of refining your program.
Define the Physician Advisor Program Objectives and Appropriate Staffing Levels
Next, we define the focus of the Physician Advisor program. The objectives for each program vary depending on the hospital or health system staffing, attending physician strengths, patient population, and other variables. Our focus is helping hospitals and health systems define the Physician Advisor program needs, scope, and performance expectations. Once objectives and expectations are established, we support determining the appropriate staffing levels.
Establish Metrics to Monitor Performance for Impact
Versalus Health helps your hospital or health system establish key performance indicators (KPIs) for your program to ensure revenue integrity and regulatory compliance. Once metrics are in place, we monitor ongoing program performance to ensure you get the most impact from the program. If your program outcomes are below your minimum standard, we propose solutions and adjust processes to ensure your program exceeds its goals.
Healthcare regulations continuously change. With new regulatory requirements, your Physician Advisor program will likely need to be updated or adjusted to account for them. With each new regulation, we evaluate the current Physician Advisor program and distill new information and use our Physician Advisor partners informed on the latest guidance and how to best incorporate these guidelines into their daily work.
Complementary Physician Advisor Services
Hospitals and health systems may determine that the internal Physician Advisor program meets the organization’s needs. Yet additional case reviews are needed from time to time to meet staffing shortages. If that is the case, the Versalus Health program supports organizations needing backup case reviews.
Physician Advisor Program Results
We’ve honed our Physician Advisor solution over time to optimize revenue integrity for our clients. As results materialize, you’ll see why supplementing your Physician Advisor program with Versalus Health Physician Advisor solution is worth the investment.
Increase Utilization Management Efficiency, Reduce Compliance Risk, and Improve Revenue Integrity
Versalus Health supports hospitals and health systems by performing thorough data analysis and providing insights from clinical and financial data. Versalus Health uses data analytics to identify revenue integrity and compliance areas that require the most attention. Versalus Health addresses any identified opportunities and then works with you to strengthen all aspects of your clinical revenue cycle. The result is efficient utilization management, improved revenue integrity, and reduced compliance risk.
Versalus Health specializes in Physician Advisor solutions to optimize revenue integrity. Book a Strategy call to learn how we can help.