Medical Advisory
Our expertise is your accuracy
We provide 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. Capelli-Schellpfeffer leads 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. Capelli-Schellpfeffer 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.
Dr. Mary Capelli-Schellpfeffer,
AIS National Medical Director
*CCC Casualty Solutions are provided by Auto Injury Solutions, Inc.
Medical Advisory Solutions
Nurse Services
We retain an experienced, in-house nursing staff to help with your clinical review needs. Our nurses provide a cost-effective alternative to keeping your own nurses on staff.
Nurse Review
Bills requiring specialized review can be routed to our nursing staff. Our nurses examine the bill and medical records and provide appropriate feedback on causality, treatment relatedness, duration and medical necessity.
Ask the Nurse
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.
Bill Audit
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.
Physician Services
We oversee 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.
Physician Review
We have a Physician Advisor panel to help when a physician’s opinion is requested to address treatment relatedness, duration and medical necessity.
Peer Review
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.
Independent Medical Exam (IME)
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.
Clinical Support Services
Code Review
Certified professional coders review codes for treatment and level of service for accuracy of the bill.
Dispute Handling
We’re here to answer billing inquiries, investigate issues, and support insurers in resolving disputes.
New Jersey Solutions
For over a decade, we have provided a proprietary 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.
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Learn more about our best-in-class medical advisory solutions.