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Appeal Review

Physician advisors work with treating physicians to optimize reimbursement and improve documentation
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    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.

Optimize patient care, reduce denials and maximize reimbursement through our unique approach to achieving excellence in utilization management.

Discuss your hospital’s utilization and denial management needs with our team.

 

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