Denial & Appeal Services

 

DRG Revisions: C.F.R. provides assessment and appeals for coding and DRG revisions whether by the CMS Recovery Audit process or by private insurance. Our coding and DRG experts are skilled with years of experience in assessing and appealing DRG revisions.

 

Medical Necessity Denials: C.F.R. provides assessment and appeals for medical necessity denials of inpatient stays. C.F.R. has an extensive record of success in appealing RAC medical necessity denials with over 90% of cases won on appeal.

 

Outpatient Denial Assessment: C.F.R. provides denial assessment, problem identification and management and resolution services for denials of outpatient and professional services.