External Peer Review
Improve practitioner performance through expert, impartial peer review
Lack of expertise, conflicts of interest, politically sensitive situations, long-held loyalties—all challenges healthcare providers often face in executing an effective peer review process. We leverage an extensive bench of over 350 trained, independent, board-certified, actively practicing providers, resulting in timely, unbiased, third-party performance evaluation across all medical specialties.
Physician/Advanced practice professional external peer review
We provide objective, evidence-based practitioner care evaluations that help our healthcare clients deliver high-quality, reliably safe care to patients. Our board-certified, actively practicing reviewers bring best-in-class specialty expertise matched to meet both single case or multi-case external reviews.
In addition to traditional case review, we also offer:
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Expanded external peer reviews: We can provide expanded reviews that include identifying patterns and trends via quality measure data analysis, and/or integrated information from confidential interviews.
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Focused professional practice evaluation (FPPE) reviews: We provide case review to support appointments and initial privileging prior to exercising privileges.
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Proctoring services: Onsite or virtual, we can provide direct practitioner observation as a stand-alone service or part of a medical record review.
Ongoing case reviews in support of OPPE/FPPE
We work with clients to support FPPE and ongoing professional practice evaluation (OPPE) requirements through the recurring and reliable review of randomly sampled medical records in order to evaluate quality, safety, and/or appropriateness of practitioner care.
Medical necessity reviews
We provide proactive and impartial reviews of cases to assess if the documentation supports patient diagnosis and treatment decisions. Expert reviews of medical necessity enhance an organization’s ability to improve the quality and effectiveness of patient care while eliminating unnecessary treatment, cost, and potential legal risk.
Do you have what it takes to become one of our external peer reviewers?
To meet growing client demand, we are expanding our esteemed physician reviewer panel. We encourage you to become an expert physician reviewer today. Submit your CV for consideration.
Our deep bench of resources enables us to accelerate reviews to meet your expedited needs.
Our unique, strategic approach delivers results
Expertise
We match credible, board-certified, actively-practicing experts with all types and volumes of case review needs—individual medical necessity, as well as federally mandated IRO reviews.
Findings
We deliver professional, concise reports that include criteria-based ratings, definitive findings, clear measurement, and feedback on performance issues and identified performance-improvement opportunities.
Focus
We help select the number and types of cases to review to ensure adequate evaluation, sparing organizations unnecessary time and expense throughout the review process.
Support
We provide post-review support to clarify findings and determine next steps, and we will defend and support findings—to include expert witness testimony as necessary—if subsequent corrective action, fair hearing, or litigation ensues.
Clinical quality & safety improvement
Through our extensive expertise in clinical quality and high reliability, and peer review consulting services, we provide identification of trends and patterns leading to improved quality and safety outcomes for individual providers and/or complete clinical service lines.
Related insights
Meet our External Peer Review leaders
Steve Mrozowski
Steve Mrozowski, MHA, CPPS, FACHE, is a Partner in Clinical Transformation and leads External Peer Review and Patient Safety. He brings more than 25 years of healthcare experience in prehospital services, quality, safety, and high reliability organizing and education.
Christian Dankers, MD
Christian Dankers, MD, serves as the firm’s Associate Chief Medical and Quality Officer and is a Partner in Clinical Transformation. Christian is focused on the expansion of clinical quality and high reliability care, bringing together capabilities in medical staff optimization, quality, patient safety, and clinical operations.
Andrew Resnick, MD
Andrew Resnick, MD, is Chief Medical and Quality Officer and is a Senior Partner in Clinical Transformation, where he leads the High Reliability Care practice.
