Welcome to CAIN Health

Physician Advisory Services

CAIN has a network of over 100 utilization review nurses and case managers as well as over 250 physicians representing 75 specialties. These services assure that CAIN’s clients achieve their critical goals of managing clinical care while maintaining regulatory compliance and sound financial performance.

Services include patient status determination, concurrent review and clinical consultation on all cases assigned, retrospective review of all cases assigned, management of all third party payer appeals, ongoing training in clinical documentation and coding for client physicians and staff, and timely updates in federal policy and payer procedural changes.

The Healthcare Industry’s most cost effective solution to quality Physician Advisory Services

CMS and OMHA Broaden Appeal Settlement Options On November 3rd, the Centers for Medicare and Medicaid Services announced on...
CMS greenlights Performant, Region 1 RAC audit activity to begin this March Performant Recovery Inc., the Region 1 & Region 5 Recovery Audit Contractor,...