The process of medical peer review involves the evaluation by practicing doctors of the medical necessity, appropriateness, and efficiency of the services performed by other doctors. Hospitals appoint physicians to conduct the review so as to monitor, correct, and upgrade patient care activities, and see that the services provided are in accordance with accepted standards and guidelines. This is a difficult and time-consuming task as the reviewing physician has to examine various hospital records and charts to assess the quality of healthcare provided. To facilitate the procedure, many professional companies provide medical peer review disability support services to benefit healthcare organizations. Support for peer-review is necessary to deal with complex care management issues, worker’s compensation cases, disability claims, group health claims, liability claims, and so on.

Comprehensive Support Services for Medical Record Review

The evaluation of the services provided by physicians is done by conducting a review of inpatient and outpatient services such as hospital use, appropriateness of patient admission, length of stay, services provided, and discharge policies. This requires the examination and organization of various medical records in a healthcare organization. Medical peer review involves:

• Collecting and classifying medical records
• Medical chart review
• Checking for missing information
• A chronological listing of medical records
• Indexing of medical records
• Checking data for compliance and thoroughness
• Comprehensive formatting of collected information
• Organization of medical case summaries and histories
• Creation of timelines

Care has to be taken to see that this review is done in keeping with HIPAA guidelines. Efficient service providers handle all patient records with the necessary confidentiality and security.

Efficient Peer Review Limits Litigation Risks

Healthcare organizations conduct the review for cases such as:

• Readmitting of the patient within 48 hrs of discharge
• Unexpected hospital deat
• Adverse reaction to the drug
• Infection acquired in the hospital
• Maternal death, bleeding, or unplanned surgery
• Unplanned shifting of the patient to intensive care
• Unplanned return to the operating room after surgery

Such cases are litigation-prone and could affect the hospital’s reputation and revenue. Medical review companies provide competent support services for hospitals to continually assess physician competence, improve the quality of patient care, and avoid litigation.

Locate an Efficient Service Provider

It is important to find an efficient provider of medical peer review support services. This would enable healthcare organizations to benefit from a range of review solutions for all types of medical records and documentation for utilization review, medical necessity review, and much more. A reliable service provider would have a team of peer review specialists to offer customized solutions for all major medical specialties and subspecialties.