In Clinical Review projects, our RNs, certified coding specialists, biostatistician, clinical staff, and panel of more than 500 peer review clinicians nationwide abstract and review medical records and documentation against claims to identify utilization and coding/billing errors resulting in inappropriate payment to providers.
Our clinical staff use nationally recognized, program relevant medical and utilization criteria to produce detailed and well documented findings that minimize appeal and help providers improve their process.
These services are provided through our wholly owned subsidiary, Permedion.
When it comes to cost avoidance, HMS has the most comprehensive approach available on the market.
