Hospital Review Services

Hospital Review Services

An innovative, cost-effective service, Advanced Medical Reviews is setting the standard for providing high quality, prompt concurrent medical necessity, retrospective and readmission reviews with emphasis on getting the appropriate admission status.

AMR follows URAC and NCQA standards for quality assurance and provide our clients with a PHI confidentiality, HIPAA Compliance, and Revenue Cycle Solution.

With the largest network of Board Certified Physician Advisors in the industry, servicing all 50 states, 365 days a year, 7 days a week, AMR is able to provide comprehensive medical recommendations utilizing case-specific patient information and industry-standard guidelines including treatment protocols and current scientific evidence-based medicine.

AMR delivers its solutions through expert, highly qualified Physician Advisors who are trained in Medicare/Medicaid rules and regulations having real-time access to clinical and regulatory information, leveraging AMR’s proprietary database of reviews through our workflow technology. These allow a more accurate and prompt clinical determination, thus maintaining clinical compliance.

The solutions Advanced Medical Reviews offers to hospitals and health systems across the nation today include the following review types:

Review Types

  • Concurrent Medicare & Medicaid Medical Necessity
  • Clinical Compliance Management
  • Inpatient & Observation Status Review
  • Cardiology Procedure Review
  • Readmission Review
  • Continued Stay Review
  • Length of Stay Review
  • Billing & Coding
  • Revenue Cycle Management
  • Utilization Review
  • Coverage Issue Review
  • Medicare/Medicaid Denials & Appeals
  • Quality of Care
  • Standard of Care
  • RAC Denials & Appeals Management
  • MAC, MIC, QIO Denials & Appeals Management
  • Medical Image Review
  • Pharmaceutical Review