Executive Health Resources | The Physician Advisor Company (TM)

Commercial Payor Retrospective Clinical Denials Management

EHR Physician Advisors will manage the entire retrospective commercial payor appeal process if a clinical denial is not able to be overturned concurrently. To date, EHR Physician Advisors have composed more than 120,000 expert physician-authored appeal letters. Unlike most nurse or non-physician-driven appeals, the EHR Physician authored appeal addresses the complex issues surrounding the uncertainty of the course of illness. The result is a 300% greater success rate with EHR when compared to other appeal programs. An aggressive retrospective appeals program demonstrates a hospital's consistent approach to denial appeal and holds payors accountable. The result is often a lasting decrease in payor denial behavior.

EHR Physician Advisors also apply a specialized workflow management technology system to ensure that each case is coded, tracked and appealed through every payor, state and regulatory level available. The result is an unprecedented ability to overturn inappropriate commercial payor clinical denials.

In addition, EHR’s proprietary enterprise technology system, EHRic™, tracks and codes every payor downgrade, denial and appeal to help EHR’s client hospitals target and eliminate the root causes of their denials.