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Reimbursement Clinical Denials Management

Case Management Consultants provides specialty trained physician advisors to assist hospitals in retrospective clinical denials management including third-party payors DRG Audits.

CMC Physician Advisors are available to perform retrospective clinical denial review, and provide expert independent physician advisor representation throughout the third-party payors review and denial management process.

CMC Physician Advisor are available at short notice to assist hospitals and health systems in responding to third-party payors request for clinical information in order for the hospitals to be in compliant with the deadline for responding to request for clinical information.

Services provided under the CMC Retrospective Clinical Denials Management program include:

  • Reimbursement Denials Appeal and Review
  • Retrospective Case Review for third-party payors Audit
  • Third-party payors DRG Audits

CMC development teams are available to assist client hospitals and health systems in utilizing CMC’s Retrospective Clinical Denials Management services without any infrastructure requirements. CMC’s Retrospective Clinical Denials Management services are designed, and customized to work seamlessly with client hospitals case management and utilization review processes.

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