Appeals Practice

Appeals Practice

Since the inception of the Provider Reimbursement Review Board (PRRB), CampbellWilson, LLP has assisted hundreds of providers in identifying, appealing and ultimately resolving their issues. Our clients range from stand-alone hospitals, to multi-system facility organizations throughout the country. Our impressive success rate has resulted in optimized reimbursement for our clients.

A few of the more notable factors about the CampbellWilson, LLP approach include:.

Our organization employs appeal specialists and reimbursement experts who are adept at identifying appeal issues, but equally important, are committed to protecting the rights of your organization at the time the cost report is filed.

Most traditional firms take an adverse approach to the appeals process. While we acknowledge there are times this method is the best course; at CampbellWilson, LLP, we take pride in cultivating a positive working relationship with Medicare Administrative Contractors (MACs), opposing legal teams and PRRB advisors. Our experiences have shown that a positive relationship tends to lend itself to better results and creates more flexibility for all concerned.

Further, as a multi-disciplinary team, we are better equipped to decipher the ever-changing complexities of the current State and Federal healthcare regulatory environment and accommodate and adapt to those changes.


Our Multi-disciplinary Team Can Assist You With The Following:

  • Identification and calculation of financial impacts for the appealable issues on both the cost report filing side, as well as the appeal filing
  • Filing of Individual/Group appeals
  • Filing of Reopenings
  • Joint Scheduling Order negotiations and preparation
  • Position Paper preparation
  • Facilitate live and telephone hearings
  • Administrative Resolution negotiation and preparation
  • Mediation

Some of the Notable Appealable Issues Include:

  • Bad Debt
  • Disproportionate Share Hospital (DSH) – SSI & Medicaid
  • TEFRA Rebasing & Ajustments
  • ESRD
  • Medicare and Medicaid Inpatient and Outpatient settlements

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