Providing Innovative Solutions for Medical and Legal Review
FHAS is one of the largest independent providers of adjudication services and medical claims’ review services in the nation. In 1996 FHAS began furnishing Medicare Fair Hearing Services to Durable Medical Equipment (DME) Administrative contractors located throughout the United States. Since that time, FHAS has expanded its scope of appeals services to include complex medical reviews for Medicare Part A, Medicare Part B, Medicare Part C PDRC Appeals, and Medicare DME Appeals. Prior to the revision of the Medicare appeals process in 2000, FHAS also furnished fair hearing services to Medicare Administrative Contractors located throughout the United States.
FHAS utilizes a network of board certified physicians, legal professionals, and other healthcare professionals with diverse specialties, who have the appropriate education, experience, and expertise to render decisions for external review requests.
Government Benefit Administration
FHAS provides medical and legal fair hearing review services to the Commonwealth of Pennsylvania, Department of Health of Human Services, Bureau of Hearings and Appeals. Fair hearing review areas include the State’s Medical Assistance Program, Medicaid Managed Care Organization (MCO) appeals for physical and behavioral health, Child Care Subsidy Program, Child Abuse Expunction, Cash Assistance, and Supplemental Nutrition Assistance Program appeals.
Comprehensive IRO Services
FHAS specializes in medical and legal IRO reviews (Internal Reviews, External Reviews, Peer Review) and maintains a comprehensive network of quality review medical and legal staff providing timely and efficient medical reviews. For over 20 years, FHAS has furnished MACs, health plans, and government agencies, including the U.S. Department of Veterans Affairs as a subcontractor and the U.S. Department of Justice with premier peer review services. FHAS provides health plans and government agencies with a proven and effective solution for handling large volumes of medical reviews. FHAS has facilitated, administered, and adjudicated over 1.4 million medical and legal reviews.
Government Administrative Services
FHAS provides a number of government administrative services to state and federal agencies. Administrative services include docketing and adjudication support services, litigation support services, and administrative hearing officer services. FHAS also houses a team of professional writers and essay reviewers who are experienced in handling the review of writing samples and/or essays for government agencies.
FHAS provides enterprise-grade solutions to healthcare and insurance industries with the Cogno-Solve software suite. Using the best in Optical Character Recognition (OCR), dynamic data storage, and business rule automation, FHAS is able to create tailor-made systems for your business needs. Our API and user interface tools will integrate directly into your current system allowing you to automate decision making and implement learning systems with minimal training.