Appeal Review
Investment Protection
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Denial Prevention Education
Protect Your Investment
Denied inpatient stays that have exceeded the payer peer-to-peer time period can be overturned before an Administrative Law Judge (ALJ) with the Office of Medicare Hearings and Appeals (OMHA). This process is more detailed and requires a greater time commitment, so hospitals request an Appeal Review to determine whether or not the case has merit. An AppriseMD physician will assess the case before discussing with a physician advisor in a clinical conference. Our physician advisors will then recommend if the appeal is appropriate to move forward to the next level of appeal.