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AXIS is an integrated partner with RMSC using the same client database, which allows maximum efficiency and seamless communication. Our nurses are specially trained and experienced in Medical Case Management, Utilization/Peer Review, Medical Bill Auditing and Nurse Consulting. Through this alliance of professionals, AXIS is equipped to meet the Medical Management needs of Employers and /or their Administrators in a quality controlled and cost-effective manner.
Medical Case Management
AXIS provides services for both telephonic and onsite Case Management. Our nurses are experienced in this challenging field, and most have obtained Certification in Case Management (CCM). Each nurse has autonomy in their field of practice, and are responsible and motivated to attain and maintain credentials and certification in their areas of expertise. Because our nurses are strategically located throughout the state of Kentucky and surrounding region, we have a working knowledge of providers of care. Credentialing is performed by an independent source to assure that each nurse remains current in licensure and certification.
Utilization Review/Peer Review
AXIS performs all types of Utilization and Peer Review, including Precertification, Concurrent Review, Retrospective Review, Appeals for Reconsideration, Specialty Match Final Determinations, and Causation Opinions. Resources used for review criteria include The Medical Disability Advisor, Milliman and Robertson Healthcare Guidelines, and The Clinical Practice Parameter for Acute Low Back Problems in Adults. Input from our panel of physicians is also utilized, and continuous quality improvement measures are ongoing in an effort to assure that fair, unbiased opinions and determinations are rendered in a timely manner.
Medical Bill Auditing
AXIS executes in-depth Medical Bill Audits which compares the billed charges to the actual medical record to ensure that items billed were ordered and the services were performed. Surgical bills are evaluated to verify that the procedures coded are accurate, and those procedures performed were anticipated during the Precertification process. All over billed charges, including procedures unrelated to the claim are identified and deducted from the bill prior to application to applicable Fee Schedules, Cost-to-Charge ratios, Per-diem rates, etc. A detailed explanation of the reductions is provided, and the Appeal Process is explained in that report.
Nurse Consulting
AXIS maintains access to Nurse Consultants through our panel of Independent Contractors. Types of services available include Legal Nurse Consulting, Quality Management Consulting, Clinical Nurse Consulting, and Rehabilitation Nurse Consulting. Reimbursement Specialists are also available to address the most up-to-date payment structures for Providers and how to maximize resources while continuing to provide Quality Patient Care.
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