Utilization review, with a physician advisor beside your team
Short answer
Aerolib provides physician advisor utilization review for hospitals. Our board-certified physician advisors review admissions and continued stays with your case management team, apply the Two-Midnight Rule and payer criteria, and document the medical necessity reasoning so each patient gets the correct inpatient or observation status.
Reviewed by board-certified physician advisors
What we review
- Initial status: inpatient vs. observation at admission
- Continued stays that need a second look
- Condition Code 44 status changes
- Escalations from your case managers
How it works
- Your case manager sends the case by text, call or the platform
- A physician advisor reviews the record the same day
- You get a documented determination with the clinical reasoning
- We follow up if the payer questions the decision
Tools behind it
- Clinical decision trees12 flowcharts, including Condition Code 44 and Two-Midnight Rule
- IP-Only procedure searchCMS Inpatient Only List, fiscal years 2020–2026
- LCD/NCD coverage validatorCheck diagnosis-to-procedure coverage before you bill
Common questions
What is physician advisor utilization review?
It's a physician's review of whether a hospital stay meets medical necessity criteria for inpatient or observation status. The physician advisor documents the reasoning so the status holds up with payers and auditors.
How fast does an Aerolib physician advisor respond?
Same day. Your team can text or call an advisor directly for status questions.
Does this replace our case managers?
No. Aerolib works alongside your case managers. They keep running utilization review day to day and bring in a physician advisor when a case needs one.
Talk with a physician advisor
Tell us about your hospital and we'll set up a call with one of our physician advisors.