Tess aids hospitals and health systems seeking reimbursement from Medicaid, Medicare, and commercial payers by navigating the administrative appeals process, as well as the external review process. She crafts legal arguments for medical necessity based on medical record analysis and reviews claims to ensure payer compliance with applicable reimbursement policies and regulations.
Prior to coming to HLS, Tess reviewed provider exclusion appeals and drafted response briefs to be submitted to the ALJ at the US Department of Health and Human Services Office of Counsel to the Inspector General. She also researched compliance with CMS Meaningful Use requirements and prepared and presented a comprehensive HIPAA training program at the Office of Legal Services for a children’s hospital. In addition, she has experience in corporate law matters, including debt collection practices and compliance with the Telephone Consumer Protection Act (TCPA).
Education and Credentials
- JD, Health Law Certificate, Saint Louis University School of Law
- BA, Cum Laude, Political Science and Legal Studies, Saint Louis University
- Bar Member, State of Missouri, District of Columbia (pending)