HLS has a long-standing history of success with complex, denied, and aged revenue cycle claims. Denied and aged claims require additional labor and cost, and have diminished outcomes in collectivity. We have several programs designed to complement the client’s in-house efforts and to add a legal arm to the client’s revenue cycle department. HLS does not have a balance limit for many of its projects. We handle claims which include but are not limited to the following issues:
- Authorization or precertification denials
- Medical or clinical denials
- Medicaid and MCO denials
- Medicare and Medicare Advantage Plans denials
- Readmissions
- Timely filing or technical denials
Our process is to analyze and research the relevant policies, contracts, regulations, and statutes that apply to the claim, as well as the payer contract. Our attorneys have claims expertise and relationships with all major payers. Many times HLS checks status and submits appeals electronically, which accelerates the claims appeals process for faster results. HLS professionals submit all levels of appeal and send appeals to third party reviewers, arbitration, and/or litigation depending on the issue and the payer. Our approach and process insures that we maximize recoveries for our clients’ claims.