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Challenge medical necessity denials



Medical Necessity Denials involve zero payment on claims. Using innovative and unique claim strategies, our Certified ERISA/PPACA Claims Appeals Specialists can overturn these denials.

AVYM helps providers understand and comply with federal regulations and guidelines that, in turn, can empower their patients to make informed decisions abut healthcare coverage and related decisions.

Have you experienced a denial?
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  • Out Of Network Healthcare Reimbursement Compliance Program

    For many hospitals and providers, “out of network” may mean “out of luck” as they face an increasing number of payers issuing total claims denials and overpayment recoupments worth millions of dollars. AVYM has developed the 2013 Out-Of-Network Healthcare Reimbursement Compliance Program (OHR), focusing on compliance. The new protocol consists of two onsite programs and is based on the most recent federal and state judicial decisions and regulatory guidance.

  • HEAT Provider Compliance Training

    OIG Provider Compliance Training at oig.hhs.gov