http://accretivehealth.com/PhysicianAdvisoryServices/tabid/322/Default.aspx

1. PHYSICIAN ADVISORY SERVICES
AccretivePAS® helps hospitals and other medical facilities receive the appropriate compensation for
the care they provide their patients.
Healthcare providers are under increasing pressure to provide greater precision in case classification and
coding. Both government and commercial payers are rigorously reviewing and – at times –denying
reimbursements. In order for hospitals to be paid for services provided, they are required to ensure all
revenue is fully compliant through proper documentation. AccretivePAS® connects our reimbursement
compliance experience with hospital physicians and case managers to navigate the crossroads of
medical necessity compliance and revenue cycle processes. At AccretivePAS®, we strive to build
enduring relationships with our clients through the highest quality service that includes rapid response,
best outcome reviews, real-time access to our experts and dedicated client service resources.
Our AccretivePAS® solution:
 Removes the burden of complex patient billing classification from the shoulders of attending
physicians so that they can focus on immediate patient care
 Uses only licensed physicians, not case managers, to handle the payer reviews and audits
 Offers a truly comprehensive physician advisory solution for payer billing compliance and
revenue preservation through the integration of our vast knowledge base and advanced
technology
 High quality, 365 days-a-year service that delivers real-time, on demand reports
According to the rules and regulations of the Centers for Medicare & Medicaid Services (CMS), the
decision to classify a patient as an in-patient or observation case for billing purposes is based on
complex medical judgment. This includes the patient’s medical history, the severity of signs and
symptoms and the facilities available for treatment among other things. Physicians are the expert
decision makers when it comes to complex medical judgment; however, physician training does not
typically allow time to master CMS guidance, standards, rules and regulations regarding billing
classifications, which are continually changing.
Our team of specialty physicians assists hospitals in navigating the path to compliant revenue by
providing concurrent level of care billing classification reviews, retrospective chart audits and appeals
management. Our innovative case management web portal connects these advisors with physicians
in the field to ensure a consistently compliant program. Our thorough secondary review process
considers medical protocols in conjunction with complex medical judgment, an evaluation of chart
documentation and peer-to-peer discussion.
By bridging our physician knowledge network with the most advanced technology and analytics in the
industry, we help hospitals and healthcare systems improve insurance payer compliance and preserve
revenue integrity.