About Avandé
Avandé ensures that all stakeholders – providers, employers, plans, and payors – make informed, data-driven decisions.
Avandé subject matter experts in clinical, regulatory, legal, and financial healthcare data management are the key to providing the highest quality medical reviews.
We work with insurance companies, third party administrators (TPAs), stop loss insurance companies, accountable health care organizations (ACOs), employers, health plans, and providers.
Leadership Team
We are physicians. We understand the practice of medicine. We have scientific training, clinical practice experience and certification to confirm our expertise. Avandé’s physician reviewers are uniquely qualified to provide informed decisions based on published clinical practice guidelines.
Advanced Data Analyses + Clinical Expertise = Informed Decisions
Clinical Review
Each medical record is reviewed against current standards of care, published clinical practice guidelines, and randomized controlled clinical trials. Many of our reviewers are academicians as well as clinicians. Our distinguished physician reviewers bring decades of clinical experience to each review.
Financial Review
Each invoice is reviewed for bunding and unbundling, resource utilization, and established lengths of stay. We consider severity of illness and any special clinical circumstances. Our database allows comparison with referenced based pricing and local facilities by region, state or zip code.
Regulatory Review
Resource utilization is evaluated using regulations established by the US Food and Drug Administration, Department of Health and Human Services, and any other applicable laws and regulations. This review ensures compliance with applicable law.
Legal Review
Avandé’s healthcare and litigation attorneys provide legal expertise to defend Avandé decisions and help to negotiate disputes. All work product is performed to a reasonable degree of medical probability. Avandé will defend its decisions and recommendations in court. We also provides legal support in cases involving provider billing disputes, accuracy, and customary and reasonable determinations.
Avandé Trust
Avandé is SOC 2 compliant. Avandé has been designated SOC 2 compliant. SOC 2 compliance recognizes our commitment to data security, privacy, and operational excellence. Avandé takes a security-by-design approach to protecting your data. We build our platform using best practices for highly available, scalable, and secure cloud applications.
Avandé is HIPAA Compliant
Avandé is thrilled to announce its attainment of HIPAA compliance. As a medical management and healthcare technology solutions provider company, Avandé prioritizes safeguarding protected health information (PHI) and ensuring patient data privacy and security. Through diligent efforts and adherence to HIPAA regulations, Avande has established robust measures to protect PHI, demonstrating its commitment to maintaining the highest standards of data protection and regulatory compliance. This milestone also shows Avandé’s dedication to prioritizing patient confidentiality and data integrity.
Our Specialties
Our specialty physician network draws on experience from all medical specialties. Each of our forensic reviewers understand healthcare issues from a clinical, regulatory, legal, and financial perspective.
Cardiology
Transthoracic echocardiogram, transesophageal echocardiogram, nuclear stress testing, stress echocardiography, tilt table, EKG, Holter monitor, event monitor, hyperlipidemia, hypertension, heart disease prevention, cardiac rehabilitation, congenital heart disease.
Cardiology, Electrophysiology
Arrhythmia, transcatheter ablation procedures, implantable cardiac defibrillators, chronic resynchronization therapy, single chamber pacemakers, double chamber pacemakers, Holter monitor, mobile cardiovascular outpatient telemetry, implantable event monitors, external event monitors, atrial fibrillation, ventricular tachycardia, atrial flutter, sudden cardiac death, supraventricular tachycardia.
Interventional Cardiology
Percutaneous coronary interventions, TAVR [transcatheter aortic valve replacement], TMVR [transcatheter mitral valve replacement], Mitra Clip, Watchman Left Atrial Appendage Closure, transcatheter closure patent foramen ovale, transcatheter closure atrial septal defect, left and right heart catheterization, endomyocardial biopsy, cardiac rehabilitation, intra-aortic balloon pump, left ventricular assist devices.
Dermatology
Skin cancer, melanoma, infections, pre-cancerous skin lesions, alopecia, dyschromia, follicular disease, contact dermatitis, seborrheic keratosis, atopic dermatitis, actinic keratosis, acne, rosacea, psoriasis, eczema, skin biopsy, cryosurgery, electrodessication and curettage, conservative excision, Mohs micrographic surgery, scar revision.
Endocrinology
Diabetes mellitus, Addison’s disease, Cushing’s syndrome, hyperparathyroidism, hyperthyroidism, hypothyroidism, metabolic syndrome, growth hormone deficiency, diabetes insipidus, pituitary disorders, fine needle aspiration, octreoscan, meta iodo benzo guanidine (MIBG) scan, sestamibi scan.
Family and Internal Medicine
Upper respiratory tract infection, arthritis, back pain, headache, fatigue, diabetes, urinary tract infection, hypertension, bronchitis or bronchiolitis, tonsillitis, anemia, pneumonia, dermatitis, depression, anxiety, epilepsy, otitis media, headache, chronic obstructive pulmonary disease (COPD), asthma, lumbar puncture, paracentesis, thoracentesis, central venous catheter placement.
Genetics
Pathology, laboratory medicine, biomarkers, gene therapy, genetic screening, novel assays, PCR, DNA sequencing, cytogenetics (karyotyping and FISH), microarrays, gene expression profiles, inborn errors of metabolism.
Hematology/Oncology
Bleeding disorders, solid tumors (liver, pancreas, lung, colon, brain, small bowel, etc.), leukemia, lymphoma, CAR-T (chimeric antigen receptor transfer), sickle cell anemia, thalassemia, thrombocytopenia, hemochromatosis, hemoglobinopathies, Factor VIII deficiency.
Infectious Disease
COVID19, HIV, hepatitis, tuberculosis, bacterial infections, viral infections, fungal infections, prion infections, antibiotic resistance, tests to detect antigens or antibodies, vaccines.
Neurology
Stroke, transient ischemic attack (TIA), aphasia, pain management, degenerative neurologic disorders, amyotrophic lateral sclerosis (ALS – Lou Gehrig’s disease),Alzheimer’s disease, Bell’s palsy, cerebral palsy, concussion, dementia, epilepsy, neuralgia, neuropathy, multiple sclerosis, Jakob-Creutzfeldt disease, Parkinson’s disease, scoliosis, stroke, vertigo, sleep apnea, chronic pain.
Nephrology
Amyloidosis, glomerulonephritis, electrolyte disorders, acute kidney disease, chronic kidney disease, renal replacement therapy, hemodialysis, peritoneal dialysis.
Obstetrics & Gynecology
Pre-conception counseling, pregnancy, delivery, post-partum care, ectopic pregnancy, endometriosis, menstrual disorders, ovarian cysts, fibroids, urinary tract infections, vulvodynia, pelvic floor disorders, infertility evaluation and treatment, contraception, cancer prevention and screening, myomectomy, cervical biopsy, cystectomy, endometrial ablations, hysterectomy, laparoscopy, laparoscopic oophorectomy, laparoscopic supracervical hysterectomy, robotic hysterectomy.
Ophthalmology
Ophthalmology-cataract, blepharoplasty, intraocular lens, retinal disease, corneal diseases, glaucoma, macular degeneration, corneal topography, corneal transplantation, electroretinography (ERG), electro-oculography (EOG) and visual evoked potentials or visual evoked response (VEP or VER), fluorescein angiography, ocular coherence tomography, Specular microscopy.
Otorhinolaryngology
Allergies, sinusitis, smell disorders, polyps, nasal obstruction, sinus surgery, middle ear surgery, tracheal surgery, laryngeal surgery, parathyroid surgery, radical neck dissection surgery, thyroid surgery, acoustic testing, airway reconstruction, head and neck cancers, sleep apnea.
Pediatrics
Neonates, infant and well-child visits, immunization.
Psychiatry & Behavioral Medicine
Substance Use Disorders, Personality Disorders, Eating Disorders, Somatic Symptom Disorder, Illness Anxiety Disorder, Conversion Disorder, Schizophrenia, Schizophreniform Disorder, Brief Psychotic Disorder, Psychosis, Schizoaffective Disorder, Depression, Bipolar Disorder, Delirium, Phobias, Obsessive-Compulsive Disorder, Dissociative Disorders, Post-Traumatic Stress Disorder (PTSD), Gender Dysphoria, Suicide Risk, Electroshock Therapy.
Pulmonary
Sleep apnea, asthma, chronic obstructive pulmonary disease, lung cancer, lung transplantation, tuberculosis, lung infection (pneumonia), COVID19, interstitial lung disease, pulmonary hypertension, pulmonary fibrosis, cystic fibrosis.
Urology
Cystoscopy, bladder cancer, kidney cancer, prostate cancer, prostate surgery, male infertility, enlarged prostate, kidney stones, urinary tract infection.
General Surgery
Surgery, General-robotic assisted, breast surgery, adrenal surgery, liver surgery, liver transplantation, pancreas transplantation, parathyroid surgery, thyroid surgery, obesity surgery, colon surgery, small bowel surgery, appendectomy, parathyroid surgery, inflammatory bowel disease (ulcerative colitis, Crohn’s disease), appendicitis.
Surgery, Cardiac Surgery
Cardiac Surgery (adult)-coronary artery bypass graft surgery, valve repair/replacement, left ventricular aneurysm surgery, aortic (ascending, transverse, descending) dissection or aneurysm surgery, mechanical circulatory assist (Left ventricular assist devices, intra-aortic balloon pump, extra corporeal membrane oxygenation [ECMO], total artificial heart), heart transplantation, arrhythmia surgery, minimally invasive procedures, deep hypothermic circulatory arrest, adult congenital heart surgery, hypertrophic cardiomyopathy (asymmetric septal hypertrophy), surgery for complications of acute myocardial infarction, atrial tumors.
Cardiac Surgery (Pediatric)
Cardiac Surgery (pediatric)-congenital (simple, complex), palliative and complete repair, valve repair/replacement, AV canal, Transposition of the Great Arteries, Tetrology of Fallot, Tricuspid Atresia, Double outlet right ventricle, Patent Foramen Ovale, Atrial Septal Defect, Ventricular Septal Defect, Total Anomalous Pulmonary Venous Return, Fontan Procedure, Ebstein’s anomaly, heart transplantation.
Thoracic Surgery
Thoracic Surgery-lung surgery, video-assisted thoracoscopic surgery, thoracoplasty, esophageal surgery, lung transplantation (single, double), chest tube thoracostomy, surgery for tuberculosis, pleuradesis, empyema surgery, tracheal surgery, lung cancer, tracheal cancer, esophageal cancer, thymectomy, tracheoesophageal fistula.
Critical Care Surgery
Surgery, Critical Care-trauma (single, multiple organ), mechanical ventilation, hemodynamic support, mechanical circulatory assist (Left ventricular assist devices, intra-aortic balloon pump, extra corporeal membrane oxygenation [ECMO]), nutritional support (parenteral, enteral, peripheral), burns, burn surgery, skin grafting.
Neurosurgery
Surgery, Neurosurgery-spine surgery, brain surgery, peripheral nerve surgery, pain management.
Orthopedic & Spine Surgery
Sarcoma, amputation, joint replacement surgery, spine surgery, pain management, amputation, trauma, arthritis, sports injuries, rehabilitation.
Plastic Surgery
Cosmetic, reconstructive, congenital.
Transplantation
Transplantation-heart, heart-lung, lung (single, double), liver, kidney, pancreas.
Vascular Surgery
Surgery, Vascular Surgery-arteriography, carotid surgery, abdominal aortic aneurysm surgery, thoracic aortic surgery, aortic reconstruction, endovascular surgery, peripheral vascular surgery, varicose vein surgery, percutaneous peripheral vascular interventions, amputation.
Legislative Healthcare Policy
Evaluation of legislative policy to identify financial, social and political impact and identify any potential unintended consequences.
Regulatory Healthcare Policy
Evaluation of regulatory policy to identify financial, social, political impact of and identify potential unintended consequences of legislative policy.
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