Our Process

At Washington & West, our unmatched Recovery Process works to overturn denials and RAC retractions and helps to prevent future denials. We believe that hospitals should receive 100% reimbursement for services provided. That philosophy, combined with our extensive experience, produces results that are among the best in the healthcare sector. Our success rates are due to the expertise applied to each and every denial. Washington & West uses a team approach with each claim. The team consists of:

• Clinicians (physicians, physician assistants, and nurses);
• Attorneys;
• Reimbursement Analysts;
• Recovery Specialists;
• Coders; and
• Administrative support staff

We meet the challenges posed by large volumes of time-sensitive, complex denials and address the combined administrative, legal and medical issues using our proprietary software application, Quantum Appeals©. Our technology, our root cause analysis,and our detailed reporting will assist your facility with denial prevention.

Our services are designed to supplement internal recovery efforts and act as an additional tool in denial recovery. There is no minimum number of cases that our clients are required to refer. Clients can refer the occasional troublesome case, OR refer cases to us on a regular basis as part of a normal routine, OR clients can have us process all of their denials on an outsourced basis. Somewhere in this continuum is the ideal solution for your hospital!

If you have any questions, please call us today at 1-800-704-5574.

The Administrative and Technical Appeal Process
The Medical Review Process
The Administrative Law Judge Hearing Process