As the sole Physician Advisor overseeing 11 hospitals at Beacon Health System, Dr. Maliha Iqbal partnered with Xsolis in 2019 to address growing caseloads and inconsistent utilization management outcomes. By adopting Xsolis’ AI-driven Dragonfly® platform alongside its Physician Advisor Services, her team achieved a 78% peer-to-peer overturn rate and completed 5,118 reviews in 2025. The combination of AI-assisted case prioritization and dedicated clinical expertise gave Beacon a scalable foundation for UM success without sacrificing clinical credibility.
This post provides details about Beacon’s journey to AI-driven UM with Xsolis.
Managing utilization management across 11 hospitals is a complex assignment for any team. For Dr. Maliha Iqbal, MD, SFHM, CHCQM-PHYADV, ACPA-C, the sole Physician Advisor at Beacon Health System, it is the daily reality. Her patient population is large and diverse, and her caseload only grew after a merger.
Dr. Iqbal knew that sustained success depended on three things: strategic collaboration across the health system and with payers, smarter peer-to-peer review prioritization, and measurable operational efficiency. Reaching those goals required a foundation built on AI-assisted prioritization, cross-team alignment, strategic peer-to-peer preparation, and ongoing data-informed improvement.
Before partnering with Xsolis, Beacon’s physician advisor (PA) model moved through three distinct phases. Each one solved a problem and exposed a new one.
Phase One: Provider-led reviews. Individual providers led their own peer-to-peer reviews. This disrupted clinical workflows and created coverage gaps whenever physicians were off service. The result was inconsistent peer-to-peer coverage with no dedicated UM expertise to drive outcomes.
Phase Two: Outsourced PA function. Beacon shifted the PA function to an external company. That approach lacked real-time visibility into clinical information and interrupted physician workflow, because providers had to be reached mid-shift for case details. Limited transparency, siloed data, and minimal cross-functional collaboration allowed denial trends to go undetected, while inefficiencies grew.
Phase Three: Reviews brought in-house. Bringing reviews back in-house surfaced a new challenge. Without a systematic way to identify high-priority cases, PAs spent time on low-yield reviews. Overturn potential went unrealized, PA bandwidth stretched thin, and no unified platform existed to measure or improve denial and peer-to-peer outcomes.
Each phase made one thing clear. Beacon needed a system that combined real-time clinical visibility with intelligent case prioritization.
To keep patients in the right status and ensure appropriate reimbursement for care provided, Beacon partnered with Xsolis in May 2019, adopting its AI-driven platform, Dragonfly, alongside Xsolis’ Best in KLAS Physician Advisor Services.
With Dragonfly, Dr. Iqbal and her UM Team are on a unified platform that provides a real-time clinical picture of each patient driven by Xsolis’ Care Level Score™ (CLS™). The CLS uses predictive analytics and machine learning, providing a numerical representation of the likelihood of inpatient or observation status for each patient. The CLS and patient acuity details provide Dr. Iqbal with the ability to prioritize the highest-yield cases.
Dragonfly also enables Dr. Iqbal to complete more reviews, even as caseloads have grown. The platform’s customizable work queue keeps high-value cases front and center.
“Our work doubled following a merger with another health system,” Dr. Iqbal explained. “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 combination matters for any health system facing rising volumes. Efficiency gains mean little if they come at the expense of clinical rigor. Dragonfly delivers both.
Xsolis’ Physician Advisor Services supplements Dr. Iqbal’s work with second-level reviews and peer-to-peer reviews as needed. According to Dr. Iqbal, the education and support built into the partnership are central to its success.
That support includes:
These elements contributed to results Dr. Iqbal is proud of including:
Dr. Iqbal shared:
“As a physician advisor, Xsolis’ Physician Advisor Services and Dragonfly help me perform better, work more efficiently, and maintain my clinical credibility.”
Dragonfly does more than prioritize cases and improve daily efficiency. It provides analytics and reporting that support peer-to-peer preparation and drive data-informed improvement. Dr. Iqbal uses these insights to monitor trends and identify opportunities for improvement. Dr. Iqbal shared:
“I’m extremely proud of the improvements we’ve seen in our observation rate, exception rate, and peer-to-peer success rate since partnering with Xsolis.”
Ongoing analytics also reveal payer behavior trends, which enable continuous refinement of denial prevention and stronger appeal strategies over time. Shared data turns payer conversations into collaborative problem-solving rather than adversarial back-and-forth.
“We meet regularly with our Managed Care Team to review denial trends and other information to share with our health plan partners,” Dr. Iqbal explained. “Xsolis data helps inform and prepare us for those discussions, bringing both parties together to improve patient care.”
Dr. Iqbal’s results of improved overturn rates, thousands of reviews completed, and stronger payer relationships built on shared data are accomplishments to be proud of. But just as important is how those outcomes were achieved, without compromising the clinical credibility she and her UM team bring to every case.
That’s the promise of Xsolis’ human-in-the-loop AI, technology that supports clinical judgment rather than replacing it. As Beacon’s patient volumes and complexity continue to grow, this combination of AI and clinical expertise gives Dr. Iqbal and her team a scalable foundation for sustained UM success.
For health systems weighing how to scale their own physician advisor programs, Beacon’s path offers a clear lesson. Pairing AI-driven prioritization with dedicated clinical expertise delivers measurable results without sacrificing the judgment that defines quality care.
Beacon Health System achieved a 78% peer-to-peer overturn rate and completed 5,118 total reviews in 2025. Dr. Iqbal also reported improvements in the system's observation rate and exception rate since the partnership began in May 2019.
Human-in-the-loop AI uses technology to support clinical judgment rather than replace it. At Beacon, the Dragonfly platform surfaces real-time clinical insights and prioritizes cases, while physician advisors apply their clinical expertise to make final decisions. This preserves clinical credibility while improving efficiency.