Note from the speaker: Maximizing the value of UR and physician advisors

Wednesday, August 21, 2019

by Kurt Hopfensperger, MD, JD

Hospitals face increasing financial pressures due to dwindling margins, and competently utilized physician advisors can have a significant impact on appropriate reimbursement leading to the financial stability of hospitals. Ten years ago, most hospitals did not have any physician advisors, but over the years they have come to realize the profound impact of this critical resource.

Since they are such a valuable clinical resource, it is critical that physician advisors work in an environment where they can review the most complex cases that require their expertise. Join me as I explore the challenges involved in elevating the effectiveness of utilization review during my session, “Evolution of Utilization Review and the Role of Physician Advisors,” at the Revenue Integrity Symposium (RIS) to be held October 15–16 in Orlando.

Artificial intelligence (AI) is emerging as a promising tool to reinvigorate revenue cycle processes, and I want attendees to understand the basics of what AI can really do for them. I feel passionately that getting utilization review (UR) right is key to preserving the overall mission of hospitals caring for patients. With new tools such as AI, there is a whole new world of possibilities providers can consider. Learn how you can maximize the value of your physician advisors and build a proficient UR process to support them. RIS attendees will learn how to rethink UR processes and leverage artificial intelligence to apply expertise at the most appropriate points in the UR process, achieving appropriate reimbursement and avoiding clinical denials.

I have heard from my colleagues that have attended RIS previously that it is a valuable event showcasing a high caliber of expertise from both attendees and speakers. I anticipate this will be a great forum to exchange lots of ideas and hopefully find solutions to the many challenges revenue cycle operations face today.

I am looking forward to exchanging ideas with other professionals in the revenue integrity space. While I will be sharing information on leading practices I have learned, I am sure I can also learn from the audience I will be speaking to.

Editor’s note: Hopfensperger is vice president, compliance and physician education, at Optum Physician Advisor Solutions.

Register for the 2019 Revenue Integrity Symposium before August 17 to get the $100 early bird discount. NAHRI members get an additional $100 discount. NAHRI members get free admission to a special members-only networking reception on October 14, the night before RIS officially kicks off. NAHRI members attending this reception should RSVP online as soon as possible to reserve their space.

Need help getting approval to attend? Click here to download a justification letter proposal that you can use to gain administrative support and approval for attending.

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Revenue Integrity