Physician Advisory Services Case Studies

Beginning this year, the Two-Midnight rule — which requires that Medicare patients admitted to the hospital must stay at least two midnights to be classified as inpatients — now applies to Medicare Advantage patients as well as those covered by traditional Medicare. Despite this new application, some Medicare Advantage plans still deny inpatient claims based on outdated guidelines, leading to increased denials and a rise in peer-to-peer reviews and appeals. Sound Physicians’ Medicare Advisor solution helps hospitals ensure compliance by providing automated screenings and expert advice, significantly improving overturn rates for Medicare Advantage denials and increasing hospital revenue.

Medicare Advisor seamlessly integrates with your Sound hospital medicine program to ensure no Medicare fee-for-service patient is overlooked. Sound physician advisors monitor patients in real-time to validate the original admission order, so hospitals maintain compliance and maximize efficiency. On average, hospitals see a 36 percent decrease in long observation stays and a $700,000 increase in annual hospital revenue.