RFP 2780- MEDICAL NECESSITY DENIAL SERVICES

Medical necessity denials account for the greatest percentage of denied dollars at NYC Health + Hospitals. The Vendor will provide denial management services for NYC Health + Hospitals by appealing medical necessity denials and other case management-related denials. The Vendor shall also provide denial trends with recommendations to reduce medical necessity denials and liaise with Managed Care on payer-related concerns.  The Vendor shall conduct all appeal work within the Epic system.