Authsnap specializes in appealing medical necessity denials for Medicare, Medicaid, managed care, and commercial payors. Our expert team crafts compelling appeal letters supported by evidence-based guidelines and reimbursement policies. Empowered by data science, our process captures all necessary data elements to support each appeal, ensuring thorough and accurate submissions. By combining advanced analytics with top expert human talent, we help healthcare providers recover lost revenue, prevent future denials, and improve overall financial performance. 

Large Volume Denials Management is best for:

Channel partners

Large health systems

Clinics with no dedicated staff for denials

Centralized UM systems

We offer a comprehensive Physician Advisory Service to support utilization management teams. Our expert physicians concentrate on two key areas: 

Admission Status Determination: We provide timely and accurate assessments to ensure patients are placed in the appropriate level of care, helping to prevent future status denials and ensuring compliance. 

Peer-to-Peer Reviews for Concurrent Denials: Our experienced advisors engage directly with insurance medical directors to address concurrent denials effectively, advocating for reimbursement and compensation that accurately reflects the acuity of patients and minimizing financial risks. 

**Our Physician Advisors follow all of our individual appeal cases, including peer review needs and all the way to the last step in the appeal process, Administrative Law Judge.

Our Utilization Management (UM) Consultation helps hospitals enhance their UM programs for better resource allocation, care quality, and operational efficiency. 

Key Benefits: 

Streamline UM Processes: We assess your workflows to recommend improvements that cut administrative burdens and boost productivity. 

Enhance Clinical Decision-Making: Our evidence-based guidelines aid clinical teams in making timely and appropriate care decisions. 

Optimize Resource Utilization: We identify ways to reduce unnecessary services and admissions while maintaining high-quality patient care. 

Improve Regulatory Compliance: We ensure your UM program meets the latest regulatory requirements and industry standards. 

Boost Financial Performance: By improving efficiency and appropriate utilization, we help maximize reimbursements and minimize denials.