Denied claims are an opportunity to turn rejection into revenue with Maria Todd. With a unique perspective gained from working with one of the nation’s largest HMOs, and a track record of tens of thousands of successfully overturned denials since 1983, Maria offers unparalleled denials management expertise for hospitals, ASCs, and physicians. 

Typical assignments include:

• Comprehensive Claim Analysis: Maria samples denied claims to identify appeal opportunities and identify wrongfully denied, appealable claims.
• Customized Appeal Strategies: There are several reasons why a claim was denied. Some are extremely complicated because they don’t follow insurance regulated rules. 
• ERISA vs Insurance Rules: Denied claims that are seemingly identical may not be because IRS and Department of Labor rules apply instead of insurance regulations. 
• Coordination of Benefits Quagmires: Some denials are mired in the staggering rules and systems associated with coordination of benefits. 
• Expert Litigation Support: Maria’s expertise has been sought by attorneys fighting stacks of wrongful denials in court, not just appealed with the carriers internally. Often claims denied for  lack of medical necessity are actually auditor errors driven by checklists. Leverage Maria’s clinical expertise to tailor  your appeals tactics using clinical insights and payer strategies learned from years of payer-side experience.
• Full-Service Appeal Management: Complete handling of the appeal process, from submission to resolution … and bank deposits!
• Education & Training: Call on Maria to train your staff to do what Maria does so they can handle future denied claims internally.