Resolution & Appeals Services

Our resolution process begins when certified coders, physicians, and clinical nurses review your claim for any billing or compliance issues. Once billing issues have been identified, our expert resolution and provider appeals team, work with the facility (usually the Hospital’s Arbitrary Committee) to address our review findings to ensure fast, fair, equitable resolution of your claim.

Should the facility choose to formally appeal our findings, our appeals team will independently review the facility’s submission and support our findings through the administrative appeals process.

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