Welcome To Medicare Appeals Development, LLC
We guarantee our results and offer one flat fee.
I take a very limited number of clients per calendar year with the comprehensive consulting package , and also offer an abbreviated package at a significantly reduced rate. As always you will only be charged charge one flat fee.
Focused and Targeted Medical Reviews
The average agency will sustain 30-45% denial rate in the initial probe. This is because the Medical Review team computers are utilizing highly refined data driven algorithms for chart selection. The RHHI knows how to cherry pick your charts that are easiest to deny payment on, and have years of experience doing this. It is the duty of the RHHI to identify payments they deem to be errant and take action, if they fail to do such they will lose their contracts.
So it is your future against theirs. How well armed are you vs. your RHHI? Without rapid intervention, most agencies will submit in excess of 120-150 charts during the process, crushing your cash flow. Many have, and many more, will lose their business. It is predicted that 1200 plus agencies nationwide will be closed while going through this process.
Data profiles are like fingerprints, no two are alike. Your data is what is getting you flagged for review, not your documentation. Has anyone started with your Data, Micro-Data, and analyzed the unique data profile you have created and submitted to CMS over the past 3 years? There are several hundred data components from the OASIS alone that make up a portion of your data profile.
A comprehensive understanding of these, in combination with several other data aspects, are the real key to fixing your problem.
If they have not, stop ,take a second, and think about this. If you do not remove the data target placed on your agency, how much you will extend the length of the review, and how much more money you will be losing.
Probe Edits turn nasty in a hurry; 40 charts is the first step to breaking you.
Immediate and decisive intervention within the first ten to fifteen charts requested will steer you into success vs. poverty. When an agency has a denial rate of 15% or greater of dollars billed vs approved, you are on the way to FMR lasting for the average agent at least 6-18 months with an approximate 50% reduction in cash flow.
Click here for the base package service description and price
Paying good money to look at ADR or probe edit requested charts you are about to send is usually a waste of money unless you can identify why they are going to be denied and stop the cyclic dysfunction before the next requests for submission of ADR\'s. The charts that are currently on census are about to be the next ADR\'s requested.Do you know how to analyze what has been requested to avoid the dysfunction in the charts about to be discharged? If not your on you are on the path to disaster, it takes someone who spends a good deal of time in front of a judge each month to do this quickly and efficiently as we know what passes the test of payment, what does not,and why. Does this describe your current consultant/attorney? If not, be prepared for a long ugly path to financial disaster.
Below you will see a precedent setting case showcased by the Medicare Departmental Appeals Board that was won on behalf of our client, cutting the debt owed by one million plus dollars. Show this to your attorney if you so choose, as we partner with law firms across the nation.
Click here to view a decision in favor of our clients posted by the Medicare Appeals Council.
Contact us for a free assessment
(916) 343-1164 or Click here to Email