Denial Rebuttals (Appeals)

We provide an end-to-end solution for denials; we develop appeal reports to clinically justify treatments from the evaluation of patient medical history and medical necessity, based on medical guidelines.

 

Daniel Rebuttals (Appeals)

We handle the development of appeal reports for a wide range of denials :

  1. Diagnostic studies (X-rays, MRIs, CT scans, EMGs etc)
  2. Psychology consults and cognitive behavioral therapy
  3. Procedures (spinal injections, sympathetic blocks, spinal cord stimulators etc)
  4. PT, chiropractic care, aqua therapy, massage, acupuncture, weight loss programs
  5. DME, surgical consults
  6. Functional Restoration Programs (FRP)
  7. Medications etc
  • High approval rate – over 70% approvals on the appeal with significant increase in direct (time spent on appeal) and indirect revenues (from authorized treatments)
  • Our service is end-to-end; includes identifying missing data, reviewing medical records, calling patients (if needed) to gather additional information and developing a detailed appeal report based on ODG and MTUS guidelines
  • Is fully secure and HIPAA compliant with quick turnaround times to maximize revenue and reduce AR days
  • Is seamless with quick transition; can get the process transitioned and start generating ‘appeals’ within a week