Certifications

EdiPhy Advisors: Education & Training provided by EdiPhy Advisors

In order to support our clients in achieving their compliance and

health utilization management goals, we listen and adapt. We listen to

our clients when they enlist our help with cases. We listen to reports

as trends are identified by our staff relative to specific attending

physicians or case managers in a given facility. We listen to the

healthcare environment and tap in to current legal and regulatory

updates and guidance. Then, we interpret and share our insights with

clients in a variety of ways, such as telephone conferences and

webinars, on-site education programs, market-based educational forums

and e-newsletters. We want our clients to be fast, adaptive and

compliant while taking care of patients. Ongoing, relevant and adaptive

education (EdiPhycation) results in being in compliance with CMS rules,

regulations and guidelines as well as billing appropriately. Being in

compliance results in avoiding legal and financial trouble in this

realm. EdiPhy Advisors is committed to providing ongoing training and

other forms of education to clients on a regular basis to continually

improve CMS and commercial compliance results.

To support our clients in adapting to changing healthcare

legislation, our physician advisors, RNs, appeals team, and data

analysts maintain ongoing conversations with client staff. This results

in day-to-day, one-on-one training as well as the identification of

bigger-picture staff education needs so EdiPhy Advisors can design and

deliver client-specific education (EdiPhycation). Meaningful

education should be designed to provide assistance to

practitioners and staff about how to operationalize regulatory

requirements and to facilitate and monitor compliance. As such, EdiPhy

Advisors provides timely education using the review of “real cases” at a

 given facility. This makes training practical and immediately

applicable while also helping physicians and case managers understand

how to address various clinical scenarios in the context of the

regulations.

Hospitals that rely on in-house physician advisors face the

additional responsibility of providing them with complete, up-to-date

education. EdiPhy Advisors trains client physician advisors through a

structured educational program uniquely designed for the in-house

physician advisor. Our thorough, consistent and on-going education

program equips in-house physician advisors with the knowledge and

understanding to accurately apply CMS regulations and guidelines in the

course and context of their reviews. In addition, we provide back-up

remote staffing for in-house physician advisors as well as excess

capacity for busy or critical time periods (such as when a number of

cases present as the first midnight approaches or when vacation

schedules necessitate additional qualified staff).

“You have to be fast on your feet and adaptive or else a strategy is useless.”

– Charles de Gaulle, first President of the French Fifth Republic after he led the Free French Forces during World War II.