Managing utilization review for a single hospital is demanding enough. Dr. Maliha Iqbal, MD, SFHM, CHCQM-PHYADV, ACPA-C, does it for 11 — as the sole physician advisor at Beacon Health System. Despite her caseload doubling after a merger, she closed out 2025 having completed 5,118 reviews, with a peer-to-peer overturn rate of 78%.
That combination of rising volume and improving outcomes didn’t happen by accident. It followed years of trial, error, and a fundamental rethinking of how AI and clinical judgment should work together.
Three phases, one recurring problem
Before partnering with Xsolis in 2019, Beacon’s physician advisor (PA) model moved through three distinct iterations, each solving one problem while creating another.
First, individual providers led their own peer-to-peer reviews — disrupting clinical workflows and leaving coverage gaps whenever a physician was off service. Next, Beacon outsourced the PA function entirely, which meant limited real-time visibility into clinical information and physicians pulled mid-shift for case details. Denial trends went undetected. Finally, Beacon brought reviews back in-house. But without a systematic way to identify high-priority cases, PAs spent time on low-yield reviews while overturn potential went unrealized.
The common thread: no unified system for real-time clinical visibility, and no systematic way to prioritize cases to maximize PA impact.
Where AI and clinical judgment meet
Beacon’s answer was Xsolis’ Dragonfly® platform, paired with Xsolis’ Physician Advisor Services. The foundation of Dragonfly is the Care Level Score® (CLS®), which uses predictive analytics and machine learning to generate a numerical likelihood of inpatient versus observation status for each patient. That score, combined with acuity details, lets Dr. Iqbal see at a glance which cases carry the highest yield before she opens a single chart.
“Our work doubled following a merger with another health system,” Dr. Iqbal said. “Dragonfly’s customizable work queue has allowed me to complete more reviews without compromising my clinical credibility. Dragonfly also helps me prepare for and complete thorough peer-to-peer reviews.”
That last point matters as much as the volume gains. Efficiency is only valuable to a health system if it doesn’t erode the clinical rigor behind each decision, and Beacon’s overturn rate of 78% suggests it hasn’t.
Support built around the technology
Xsolis’ Physician Advisor Services adds a second layer: supplemental second-level reviews and peer-to-peer support as needed, backed by Xsolis University onboarding, clinical rounds led by Xsolis PA leaders, and a dedicated account team.
“As a physician advisor, Xsolis’ Physician Advisor Services and Dragonfly help me perform better, work more efficiently, and maintain my clinical credibility,” Dr. Iqbal said.
Turning data into payer strategy
The impact extends beyond daily casework. Dragonfly’s analytics and reporting give Beacon’s team visibility into observation rates, exception rates, and peer-to-peer success rates over time — data Dr. Iqbal uses to shape conversations with payers rather than react to them.
“We meet regularly with our Managed Care Team to review denial trends and other information to share with our health plan partners,” Dr. Iqbal said. “Xsolis data helps inform and prepare us for those discussions, bringing both parties together to improve patient care.”
A model built to scale
Beacon’s results include a 78% peer-to-peer overturn rate, more than 5,000 reviews completed by a single physician advisor in a year, and payer relationships grounded in shared data. This reflects what Xsolis calls human-in-the-loop AI: technology built to support and enhance clinical judgment, not replace it.
For health systems evaluating how to scale a physician advisor program without adding headcount, Beacon’s experience offers a clear takeaway: pairing AI-driven prioritization with dedicated clinical expertise can deliver measurable results without sacrificing the judgment that defines quality care.
To hear more from Dr. Iqbal on Beacon’s experience, watch the video series here.
To learn more about Beacon Health System’s approach to physician advisor scaling, read their full success story.
