Complete Revenue Cycle Coverage.
From ER to Appeals.

In the Emergency Room

The Emergency Department is where clinical and financial risk originates. bServed positions its multidisciplinary team at the point of entry — validating medical necessity, assigning correct admission status, and working closely with ED providers.

• 24/7 concurrent review from first patient contact
• Real-time medical necessity validation against InterQual and MCG criteria
• Direct communication with ED providers

Post Stabilization

After acute stabilization, the revenue cycle enters one of its most complex phases — particularly for out-of-network patients and those transitioning between care levels. bServed manages this period with dedicated clinical review and payor communication to ensure continued authorization and correct level-of-care designation.

• Real-time management of post-stabilization authorization requirements
• In-network and out-of-network patient coverage
• Level-of-care monitoring as clinical status evolves
• Coordination with payor case managers for complex continued stay scenarios
• Documentation support to maintain defensible criteria alignment throughout

Securing Authorizations

Authorization is not paperwork — it is the financial foundation of every inpatient claim. bServed secures authorizations concurrently, before discharge, using payor-specific clinical packets and real-time communication workflows that dramatically reduce the risk of retroactive denial.

Payor grids are maintained continuously to ensure every submission is delivered at the optimal moment, in the format each payor requires.

• Payor-specific clinical packet preparation for every admission
• Notification submitted at optimal timing per maintained payor grid
• Same-day authorization follow-up when decisions are pending
• Immediate escalation when authorization is delayed or at risk
• Real-time alignment between authorization status and clinical orders

Concurrent Reviews

Continued stay authorization requires daily clinical review — not weekly check-ins. bServed performs concurrent reviews on all active patients, submitting same-day updates to payors as clinical status changes and ensuring authorization coverage never lapses during a hospitalization.

• Daily review of all active inpatient and observation cases
• Same-day continued stay submissions when clinical status changes
• Criteria-aligned documentation updates throughout the stay
• Tight expiration tracking across all active authorizations
• Physician advisor escalation for cases approaching criteria thresholds

Level of Care Optimization

Incorrect level-of-care assignment is one of the most financially damaging errors in hospital revenue cycle management. An inpatient case incorrectly placed as observation can mean tens of thousands of dollars in lost reimbursement — per case. bServed corrects level-of-care decisions at the point of entry, before they become claims.

• Real-time LOC review beginning in the Emergency Department
• Continuous reassessment as patient condition evolves during the stay
• Physician advisor involvement for all borderline or disputed cases
• Payor-specific criteria application to support every level-of-care decision
• Documentation structured to withstand payor scrutiny at every level

Denials Prevention

Preventing denials is dramatically more valuable than appealing them. Every prevented denial means full, immediate reimbursement — no delays, no administrative burden, no uncertainty. bServed's primary focus is resolving denial risk during the stay, not after the claim is submitted.

• Real-time identification of documentation gaps and criteria misalignment
• Immediate clinical updates when payor requirements are not met
• Proactive physician advisor engagement before denial risk escalates
• Payor-specific compliance tracking across all active cases
• Reporting that surfaces systemic denial patterns before they compound

Appeals & Denial Recovery

When denials do occur, speed and completeness determine whether they get overturned. bServed manages the full appeals process — categorizing denials immediately, building clean clinical packets, and submitting within eligibility windows before recovery becomes impossible.

• Immediate denial categorization to triage by type and priority
• Fast preparation of complete, payor-aligned clinical appeal packets
• Submission within all eligibility windows — no missed deadlines
• Peer-to-peer review coordination with physician advisors
• Retrospective review support for complex or aged denial portfolios

Behavioral Health Utilization Management

Behavioral Health presents unique challenges that general UM programs are not equipped to handle — rapid patient status shifts, stricter payor documentation requirements, involuntary hold transitions, and heightened criteria sensitivity. bServed deploys a dedicated Behavioral Health UM team with specialized clinical expertise and payor-specific documentation workflows.

• Dedicated BH clinical team separate from general UM operations
• Real-time tracking of voluntary and involuntary hold status transitions
• Payor-specific documentation packets built for BH review criteria
• Physician advisor involvement for high-acuity and complex BH cases
• Concurrent BH deployment alongside hospital-wide UM — no phased delays