Physician Advisory Services

Background
San Bernardino County, on behalf of Arrowhead Regional Medical Center (ARMC), is seeking proposals from qualified proposers to provide Physician Advisory Services. ARMC is a 456-bed university-affiliated teaching hospital that provides a full range of inpatient and outpatient services and emergency care for approximately 130,460 County residents. The goal of this contract is to enhance the utilization review process for patients requiring inpatient stays who do not meet established criteria.

Work Details
The contractor will provide physicians to conduct secondary utilization reviews for all patients requiring inpatient stays but not meeting criteria using state-approved InterQual or MCG software. Key deliverables include:

1. Timely responses (60 minutes or less for Emergency Department cases, two hours for medical necessity).
2. Onsite physician advisor services when requested by ARMC.
3. Peer-to-peer reviews to mitigate payor denials and level of care reviews for all payors.
4. Ongoing education regarding clinical documentation and status recommendations.
5. Real-time reporting on cases referred, inpatient vs observation cases, and time to completion for each review.
6. Compliance with HITRUST Common Security Framework standards for any software used to store protected health information.

Period of Performance
The contract period will be for a maximum of five years beginning on the date the contract is fully executed or another effective date specified in the contract.

Place of Performance
Services will be performed at Arrowhead Regional Medical Center, 400 North Pepper Avenue, Colton, CA 92324, or remotely when approved by ARMC.