Appeals and Hearings

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The appeal process can be burdensome and costly for the provider. Sometimes it is cost efficient to consult with a qualified consulting group who can examine the denials and assist the provider with developing the best opportunity for appeals.

The MJS appeals team is geared to provide the best support possible for overturning denials whether the decision is for the provider to self-appeal or request complete handling of the appeal by MJS.

The MJS appeals team is fluent with coverage policies, national and local coverage determinations, coding guidelines, and documentation standards that apply to physician practices, home health, hospice, and suppliers. Arguments for each level of appeal can be provided to the provider as requested.

MJS is also experienced with hearings before the State Office of Administrative Hearings (SOAH) and the Office of Medicare Hearings and Appeals (OMHA). Working independently or with provider’s legal representative, we can provide expertise in process and testimony to assist the provider with best outcome possible.