AIS provides extensive medical advisory services designed to help improve claims outcomes and accuracy. Our dedicated staff of experienced nurses, board certified physicians, and certified professional coders provide a wealth of medical expertise to serve your first and third party casualty needs.
Dr. Mary leads our medical advisory services and New Jersey program. She is also responsible for quality assurance for clinical review, medical credentialing in expert clinician recruitment, and educational outreach. Prior to AIS, she served as Medical Director for Loyola Occupational Health Services and Associate Professor at Loyola University of Chicago. Dr. Mary is an experienced presenter and published author in medicine and engineering on injury and safety. She holds an MD from University of Florida and a Masters in Public Administration from University of Wisconsin-Parkside.
<br/><small>Dr. Mary Capelli-Schellpfeffer,<br/>National Medical Director</small>
AIS retains an experienced, in-house nursing staff to help with all of your clinical review needs. Our nurses provide a cost-effective alternative to keeping your own nurses on staff.
The bill review engine automatically flags and routes bills requiring specialized review to our nursing staff. Our nurses examine the bill for causality, treatment relatedness, duration and medical necessity.
Our nurses are available by phone at no charge to answer any questions you may have on injuries and medical services. A comprehensive case review is available for an upgrade.
Large bills, such as hospital bills, represent a significant cost and investment of time to review. Our nurses conduct a line by line audit for accuracy of the charges.
AIS oversees a national network of independent physicians who provide medical professional services. Representing a broad range of specialties, these clinicians are available to review medical documentation, and /or conduct independent medical examination (IMEs), as needed.
We have a Physician Advisor panel to help when a physician’s opinion is requested to address medical necessity on individual medical bills.
AIS provides physicians of the same specialty to conduct a peer review of medical documentation and provide a case summary report. Physicians evaluate causality, treatment relatedness and medical necessity.
AIS offers a streamlined referral process to a national network of board-certified, credentialed specialists. Clients simply submit a request, and AIS handles the rest. MedFlow Adjuster Desktop tracks status from submission to final report.
Certified professional coders review codes for treatment and level of service for accuracy of the bill.
We’re here to answer billing inquiries, investigate issues, and support insurers and their defense counsel in resolving disputes.
For over a decade, AIS has provided a proprietary, turn-key solution to help clients comply with the unique regulatory requirements for New Jersey first party casualty claims. Our New Jersey solution completes our national offering, allowing clients to manage their first and third party casualty needs through one partner.
Learn more about our best-in-class medical advisory solutions.