From time to time, organizations may be in need of obtaining a third-party physician reviewer to evaluate the standard of care and medical necessity of the care provided by one of its physicians. At times, these needs arise due to an apparent wRVU abnormality, a peer complaint, a governmental investigation, or other factors.
Coker has a team of board-certified physicians reviewers in a variety of specialties available to perform such reviews. Our physician reviewers will evaluate to documentation and images available for various procedures to evaluate whether the standard of care is being met in accordance with CMS and specialty guidelines and make a determination of whether medical necessity was met. Information obtained in these reviews can be vital to an organization in need of expert opinion to make a determination of next steps.
Coker’s expert physician reviewers are available in the following specialties:
Concerns about physician clinical performance and medical necessity require a comprehensive and nuanced specialty review. Coker’s team of experts can provide a specialty-specific review to provide you with a determination of whether an issue truly is present and if so, the scope of such a determination.