Physician Advisory Solutions

Improve your case management with our clinical expertise

R1 Physician Advisory Solutions (PAS) help clinicians navigate the regulatory and contract environments to support timely delivery of necessary care, ensure billing compliance and reduce clinical denials. Precise case review and counsel by our advisors uncover the root causes of denials, speed claim processing and optimize reimbursement. We help providers consistently improve quality and compliance using intelligent technology and best practices for clinical documentation, regulatory alignment and coding.


The proof is in the performance

7-to-1 Level of Care ROI

80% success rate in Peer-to-Peer cases

68% clinical denial recovery rate

30+ staff minutes saved per case

More than 100 expert clinicians

Integrated clinical workflow platform

Optimized case prioritization

On-demand reporting

Expert clinical support for quality outcomes

Enable more accurate documentation on concurrent and post-discharge hospital stays to support compliant admission status and mitigate denials.

A team of nurses use screening criteria to ensure compliance of the admission status order and Medicare’s condition of participation. We identify and mitigate cases at risk for denial across all payers, supporting or supplementing your clinical staff so they can focus on delivering high-quality care.

Navigate the intricacies of complex and ambiguous Medicare regulations so you can bill appropriately for the care you deliver. Our highly trained, licensed physicians review the documentation on concurrent and post-discharge hospital stays to support compliant admission status. We prepare a fully written consult and then discuss the recommendation and supportive reasoning with your case manager and physician to enhance documentation and prevent denials.

Our concurrent denials management service provides experienced physician advisors to discuss commercial denials with the payer on your behalf during a patient’s hospital stay. R1 physicians and teams review all pertinent records and arrange a phone consultation with the denying medical director. Our system automatically informs case managers when insurance companies have been contacted and updates the outcome to help analyze payer behavior.

Looking to learn more about us? It all starts here.