Appeals Process / Expert Witness
ACS has worked with hospitals on DRG and medical necessity denials since the 1985. Whether it is an appeal of an adverse decision by the MAC, CERT, RAC, SMRC, ZPIC/UPIC, or commercial payor, ACS has successfully worked with clients to get inappropriate decisions overturned. ACS has successfully served as expert witness in arbitration for attorney firms as well as the OIG.
ACS is available to assist with review of records prior to submission to the payor (or other external review agency) as well as medical record review and writing of appeal letters when indicated. We welcome the opportunity to assist client hospitals with this important process.