Horizon Fully-Insured No-Auth/Emergency

This is a 2014 case wherein the primary charges were $30,735.00.  The case was forwarded to CH Revenue Management Solutions after the provider’s claim was denied as “the authorization for the service was not approved”. CH Revenue Management Solutions appealed twice claiming that the provider did obtain authorization, as well as the fact that the doctor provided services to the patient who presented initially through the emergency room. CH Revenue Management Solutions obtained 90% of billed charges for our client; and a check for $27,661.50 for our client.

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