Clinical Appeals Management
Appeals Management is a critical component of hospital revenue integrity strategy. We assist payers by assuring you receive accurate reimbursement for the services you provide through the identification, management and education required to improve claims recovery efforts.
As part of our solution, our clinical specialists review claims along with medical records for medical necessity. We identify the services rendered and validate that the appropriate levels of care are billed correctly, addressing issues regarding documentation, lack of medical necessity and plan of care.