Navigating Healthcare’s
Most Complex Challenges
With Precision and Integrity
Expert advisors helping healthcare organizations, providers, payers, and legal teams achieve compliance, resolve disputes and optimize revenue integrity.
Your Partner in Compliance, Revenue Integrity, and
Dispute Resolution
Since 1995, EdiPhy Advisors has been a trusted resource for healthcare providers, payers and law firms seeking expert guidance in a shifting regulatory environment. Our multidisciplinary team, comprised of board-certified physicians, coding experts, attorneys and compliance specialists, delivers tailored solutions that address your organization’s most pressing challenges.
From navigating the No Surprises Act’s Independent Dispute Resolution process to strengthening clinical documentation, our approach is rooted in deep expertise, ethical practices and measurable results.
Comprehensive Services, Customized for Your Needs
We combine medical, legal and regulatory expertise to help you meet your goals with confidence.
Physician
Advisor Services
Utilization management support, clinical documentation improvement, and denial management.
Independent
Dispute Resolution (IDRE)
Under the No Surprises Act, resolving payment disputes between providers and payers.
Revenue Cycle & Coding Consultation
Expert reviews and
assessments to optimize reimbursement.
Denials Management & Appeals
Comprehensive support handling denials and guiding appeals for better outcomes.
Medical Necessity & Payment Disputes
Expert review and consultation to resolve medical necessity challenges and payment disputes.
Utilization Management Nurse Services
Experienced nurse reviewers supporting utilization management and case review processes.
Independent Review Organization (IRO)
URAC-accredited Independent Review Organization Support for Corporate Integrity Agreements and compliance oversight.
Regulatory & Compliance Support
Guidance for hospitals, health systems, and legal teams navigating complex regulations including Corporate Integrity Agreement (CIA) Support.
Decades of Experience. Nationally Accredited. Client-Centered.
- URAC-accredited Independent Review Organization since 2014
- NCQA accreditation in Utilization Management (2025)
- SOC 2 Type 2 Certified for security and operational excellence
- Majority female-owned
- Nationally recognized by providers, payers, and legal teams for responsiveness, accuracy, and collaborative problem-solving
When you work with EdiPhy, you gain more than a consultant — you gain a long-term partner dedicated to your success.
A Stronger Team, Broader Expertise
EdiPhy Midwest was formed in 2025 with a team of highly experienced professionals in clinical documentation, coding, compliance, and revenue cycle consulting. This expansion strengthens our ability to deliver comprehensive, specialized support to healthcare organizations, payers and legal teams nationwide.