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NEWS & RESOURCES

Case Studies

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What Happens When An Unqualified Clinician Denies Your Hospital’s Claims?

Today, hospitals hear over and over that medical necessity criteria was not met when a payer denies a valid claim.

A Successful Clinical Appeal Is A Win For The Hospital And The Patient

The medical billing world is complex. One particularly complicated aspect is the concept of medical necessity, which can be interpreted differently from payer to payer.