Premier Medical Appeals (PMA) seeks to partner with hospitals, physicians, and other healthcare providers to safeguard revenue. We recognize that the profit margin for the healthcare provider has contracted and that every reimbursement is important. Premier Medical Appeals has an experienced staff of highly trained clinical personnel. This team is capable of navigating the unique and often complex payer requirements that must be met in order to receive reimbursement for services. Our expertise is in developing an appeal response to all types of payer denials. Our clients have profited from our knowledge of evidence-based medicine and level of care criteria. As an example, the PMA team successfully overturned $26 million in denials for a single hospital system over a two year period.

Our Vision:

To promote sustainable financial health for our client partners by delivering appeals that are prompt, persuasive and designed to attain the highest overturn rate in the industry.

Our Mission:

To promote and foster our client's profitability by crafting expert appeal letters that address the complex and often contradictory reimbursement model.

Our Values:

Our operating discipline revolves around respect and ethical behavior as the basis for everything we do. We embrace health in all its forms, and we seek to create and maintain a culture of health in order to better serve our clients. Our core values are:

  • Transparency
  • Integrity
  • Reliability
  • Diversity
  • Charity
  • Respect

Scope:

Premier Medical Appeals is seeking to partner with providers to overturn denials of the following types:

  • Medical Necessity
  • Two Midnight
  • Lack of Authorization
  • Coding
  • Medicare Audits
  • Medicaid Audits

Additional Services

  • Provider Liable Review
  • Retrospective Review

Reporting

Premier Medical Appeals will be able to help the provider sustain profitability by identifying the denial cause. Each month PMA will generate a detailed report of all denials by type, payer and physician. This information can be used by the corporate officers and medical executives to heighten the knowledge of the providers as a means to help reduce future denials. PMA team members can also be engaged to participate in these training sessions to enhance the learning opportunity.


Copyright 2016 - Premier Medical Appeals