Experienced clinicians from all areas of the U.S. to work on denials remotely

Experts in nationally recognized criteria (InterQual & Milliman)

Industry leaders in Medical Necessity Recovery

Support of 125 physicians, all specialties & dual-boarded reviewers

Case assignment sent to clinician with experience in specific specialty practice

Affordable rates based on case complexity

Urgent Case Review with
48 hour turnaround time

Additional support on external appeals & complaints. Appeal to state government insurance board

No mandatory long term contracts

Inpatient, observation, and outpatient cases.

Application of the two midnight rule

Payments canceled for surgery due to lack of prior authorization

Underpayments based on level of care denials

Care delay, delay in discharge

Inpatient readmission denials

Denials for lack of authorization/notification

Denials for outpatient drugs, surgical procedures, advanced imaging, and treatments.

Recoupment denials

DRG down-grades

Complex case evaluation such as LTACH

Denials of timely filing

Retroactive authorization

Investigational/experimental

Expedited appeals for urgent cases