Physician Advisor Programs

Regulations, contractual rules, and hospital processes can be complicated and can change constantly. A physician advisor can work side-by-side with physician peers as the liaison with many other stakeholders to provide the highest value care possible

A physician advisor is an administrative role that has been growing in popularity over the years, especially in pediatric organizations. The physician leader acting in this role works with care coordinators/UM nurses and the care team to triage patients to the appropriate level of care, manages length of stay, facilitates patient flow, educates providers on documentation issues, and acts as a liaison between their physician peers, hospital administration, and payers. The consulting associates at PRG have been at the forefront of the pediatric physician advisor movement and can help your organization design and implement a program that best serves your strategic priorities.

Potential areas for assessment and intervention

  • Physician Advisor responsibilities and priorities for your organization
    • Helping physicians and UM nurses with appropriate placement in the correct status (inpatient vs outpatient with observation services)
    • Length-of-stay (LOS) optimization and managing to expected LOS
    • Overcoming barriers to patient flow by minimizing or preventing avoidable delays
    • Improving proactive discharge planning and discharge timeliness
    • CDI query follow up and documentation education
    • Concurrent denials prevention and peer-to-peer discussions with payers
    • Retrospective denials appeal letter writing
    • Committee leadership:
      • Utilization management (UM) committee
      • CDI committee
  • Job description development based on priorities of the role
  • Applicant screening
  • The orientation of new physician advisors
    • Presentations, materials