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NorthGauge adheres to a philosophy that peer review is not simply a report; it’s a process. That’s why we actively manage every project and remain engaged all the way through fair hearing if necessary. We do this with a keen focus on your success in driving the highest quality patient-centered care. Count on NorthGauge for support with: • Focused and Ongoing Professional Practice Evaluation • Medical necessity determination • Documentation and coding compliance • Privileging decision support • Root cause analysis • Fair hearings • Fraud and abuse mitigation • New service quality monitoring • Proctoring • Practice acquisition due diligence • Litigation support MEDICAL STAFF DEVELOPMENT, GOVERNANCE AND ALIGNMENT Call upon NorthGauge to efficiently and accurately evaluate: • Medical staff effectiveness • Physician performance • Bylaws • Employment contracts • Physician preparedness for accountable care and emerging reimbursement models Whether to manage a major crisis or affect systems improvement, our rigorous assessments and practical advice have driven critical change in support of corporate objectives.
CLINICAL PERFORMANCE IMPROVEMENT It might seem strange to hear from a consulting firm that the patient is at the center of all we do. But we’re not most consulting firms. We never forget that the better your performance, the more favorable the impact on the lives of your patients, which could be any one of us, our friends or family members. Whether amidst a crisis or a proactive campaign to improve outcomes, we get to the heart of the issues quickly, and offer practical solutions that support patient safety and clinical excellence. COMPLIANCE Much of what we do either directly or indirectly identifies and mitigates compliance risk. Applying our peer review services, coding audit and advisory resources, and operational consulting expertise, we help our clients make sure they don’t breach regulatory or accreditation standards. Whether evaluating medical necessity, appropriateness of documentation, adherence to national or local coverage determinations, or physician contracts, NorthGauge is a vital compliance resource. LITIGATION AND RISK MANAGEMENT SUPPORT Top healthcare law firms across the country rely on NorthGauge for decision support relating to physician practice. We have assisted with litigation, federal investigations, qui tam threats, and payer disputes. Should the case be settled? How strong is our position? Does the whistle blower’s claim have merit? How extensive is our exposure? With assurances of credibility, defensibility and timeliness, NorthGauge provides invaluable decision support.
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