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Hospice ADR & Medical Review Defense

Strategic Appeal Writing & LCD-Based Documentation Correction

Hospice providers are facing increased medical review activity from MACs and SMRC. Many overpayments stem from LCD misalignment, unsupported F2F encounters, and documentation gaps within benefit periods.

Our Approach

We Combine:

  • Benefit Period Eligibility Audit

  • Structured ADR & Appeal Writing

  • LCD-Based Documentation Alignment

  • Mandatory Documentation Training

We address both the recoupment and the root cause.

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Services Include

  • ADR Review & Appeal Writing

  • Overpayment Strategy & Response

  • Eligibility Audit (Benefit Period Specific)

  • F2F, RN Recert & CTI Review

  • Mandatory Documentation Training (1–3 Days)*

Who This Is For

  • Agencies currently under ADR

  • Hospices with SMRC overpayment letters

  • Agencies preparing for medical review

  • Hospices with repeat documentation denials

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Why Is Training Required?

To reduce repeat denials and align documentation with CMS LCD guidelines, documentation training is required with most appeal engagements.

Training may be conducted virtually or on-site.

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*Additional training days available as needed. No guarantee of claim reversal; eligibility is dependent on clinical documentation and LCD support.

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