Independent clinical expertise for confident decisions
Clinical decisions require experienced physician oversight, objective evaluations, and evidence-based recommendations. TotalMed’s Physician Review Services provide health plans with access to board-certified physicians across a broad range of specialties to support utilization management, appeals, quality initiatives, and complex case reviews.
Whether you need additional physician capacity, specialty expertise, or ongoing clinical review support, our physician network helps your organization deliver consistent, defensible, and timely determinations.
Physician Review Services Include
Our physician network supports a variety of clinical review functions, matched to cases based on specialty expertise.
Prior Authorization Reviews
Independent physician evaluations that help determine medical necessity and appropriate levels of care before services are delivered.
Appeals Reviews
Objective physician reviews for first-level, second-level, and complex medical appeals supported by evidence-based clinical rationale.
Peer-to-Peer Consultations
Professional collaboration between physicians to discuss treatment plans, clarify documentation, and resolve challenging cases.
Concurrent & Retrospective Reviews
Clinical oversight that supports appropriate utilization, quality care, and policy compliance across the continuum of care.
Quality & Medical Necessity Reviews
Comprehensive physician assessments that support quality improvement, regulatory compliance, and defensible decisions.
Clinical Expertise Across Multiple Specialties
TotalMed’s physician network includes experienced specialists across a wide range of medical disciplines.
Cardiology
Emergency Medicine
Family Medicine
Internal Medicine
Neurology
Oncology
Orthopedic Surgery
Pediatrics
Psychiatry
Pulmonology
Rheumatology
Gastroenterology
Physical Medicine & Rehabilitation
Women's Health
Surgical Specialties
And many more
Why partner with TotalMed?
01
Board-Certified Clinical Expertise
Experienced clinicians with extensive practice experience across numerous specialties and subspecialties.
02
Evidence-Based Decision Making
Every review is supported by current clinical guidelines, peer-reviewed literature, and your organization’s policies.
03
Flexible Review Capacity
Ongoing physician review services or additional support during periods of increased volume.
04
Faster Turnaround Times
Efficient review processes reduce delays while maintaining the quality and clinical integrity complex decisions require.
05
A Trusted Healthcare Partner
We collaborate to improve efficiency, strengthen review programs, and support better outcomes.
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Strengthen your clinical review program
Access experienced physician reviewers who understand today’s healthcare landscape and deliver objective clinical expertise when it matters most.