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Healthcare Management and Review

Electronic Review Platform

HI RESolution™, HealthInsight’s electronic review system, provides a safe, secure alternative to meet your case review needs.

A secure Web-based environment for physician review

User-friendly lay-out and design

Comprehensive letter and documentation templates

Complete electronic case storage and retrieval mechanisms

A simple one-step QIC response component

Local/National Peer Physician Reviewer Network

Our specialty-matched physician reviewers perform:

Independent third-party external review

Medical necessity determinations

Quality of care determinations

Appeals review: standard and expedited

Patient Protection Program

We can help you resolve your quality of care concerns.

Toll-Free patient HelpLine

Specialty-matched physician reviewers

Facilitation of quality improvement

Licensed mediation services

Medical Billing/Audit Services

Retrospective audits for individual claims or payment monitoring.

Medical coding validation

Billing audit review