Medicaid Payer Denials

HLS has a proven track record of collecting on claims denied by Medicaid payers, including Medicaid MCOs as well as state Medicaid agencies. We have a thorough understanding of Medicaid rules in all of the states in which we work, which we deploy to strengthen our appeals with a legal grounding. We are familiar with all levels of appeal, including the option to pursue Medicaid denials to administrative hearings, legal settlements, and independent review organizations. We utilize these levels of recourse beyond the internal appeals process to hold Medicaid agencies and MCOs accountable when they fail to appropriately review our appeals and approve payment for medically necessary services.