Dispute Resolution Services
In a constantly changing environment involving increased costs, payers and providers are focusing greater attention on the resolution of healthcare payment and billing disputes. Utilizing specialty matched reviewers, including physicians and Certified Professional Coders, IMEDECS conducts dispute resolution services to resolve these issues and helps its clients avoid litigation and arbitration.
The primary areas of dispute in these reviews are:
- Separate admission based on premature discharge
- Medical necessity of continued care/unnecessary delay in discharge
- Medical necessity of admission and appropriateness of inpatient level of care versus observation
- Severity of illness
By choosing IMEDECS for your dispute resolution services, you ensure a review that is:
Neutral – The review will be handled objectively by a physician who attests that they have no conflict with the provider or the payer in question.
Efficient – IMEDECS uses its proprietary client portal, AccessIMEDECS, to manage the process. AccessIMEDECS allows both parties to submit and review documentation.
Timely – IMEDECS conducts the reviews in timeframes agreed upon by the parties. IMEDECS averages less than nine days turn around per case.