Guest guest Posted August 11, 2011 Report Share Posted August 11, 2011 I was involved in a couple of ALJ hearings a few years ago. One was done over the phone and one was done in person. He came to the facility and we presented our case. The key to a successful hearing is organized documentation assuming the documentation in there in the first place!! Focus will be on the reason for denial which is typically treatment not considered " reasonable and necessary " . We won one hearing and lost the other but I expected to lose one because the documentation did not meet CMS expectation- lesson learned. Good luck Sherry Colson Director of Rehabilitation Quote Link to comment Share on other sites More sharing options...
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