While your expert billers and coders work in their areas of expertise, allow us to work in ours- overturning adverse medical determinations with no cost to your practice unless we are successful.
How We Can Help
What is the current success rate of the medical appeals submitted by your practice?
Do you have patients whose care has been denied as “not medically necessary” and/or “experimental/investigational”?
Do those addressing these appeals for your practice understand the medical aspects of the case, and are they capable of interpreting and describing the needs of a patient?
Are there patients for whom you believe a particular treatment would be safer and/or more effective but the likelihood of an insurance denial discourages you from providing that level of care?
Do you find that you are spending money to hire and train new employees to address appeals - regardless of the outcome of the cases?
Are you spending a considerable amount of your time addressing patient cases from the past? If “yes”, does this prevent you from being able to spend as much time with your new patients?
How We Can Help
Running a physician practice is all-encompassing. The delivery of quality patient care and the financial health of a practice are of the utmost importance, and one cannot exist without the other. In today’s healthcare environment, the financial viability of a physician practice requires a sound strategy for the management of medical appeals- one associated with minimal up-front costs and a high success rate. Using existing billing and coding staff to manage appeals takes those individuals away from their areas of expertise, thereby reducing efficiency.
Successful outcomes for medical appeals typically require involvement of individuals with a clinical background to adequately write, research, and defend the delivery of a particular medical treatment; however, hiring and training employees to manage medical appeals is associated with significant expense, regardless of appeal outcomes. With a pay-for-performance business model, Medical Mediation Services offers the solution.
Allow our highly trained staff of medical writers and researchers to serve as your medical appeals resource to minimize overhead costs for your practice while capturing revenue associated with cases that have been medically denied.