Medical Review
Medical reviews involve the collection and clinical review of medical records and related information to ensure that payment is made only for services that meet all Medicare coverage, coding, billing, and medical necessity requirements. Medical review allows for more efficient patient outcomes and revenue cycles and let healthcare professionals focus on care for individual patients improving everyone’s quality of life. Our Medical reviewers identify errors through claims analysis and/or medical record review activities.
- Medical Overview of the clinical trials
- Training of Study Teams and sites
- Review or audit medical records for completeness and accuracy.
- Often coordinate in-service meetings to educate the medical staff on proper documenting procedures.
- Continue self-learning of new coding, government and insurance guidelines.
- Quality Control check for complete, legible documentation.
- Review comment within projected timelines
