Jackson Davis HealthCare

Jackson Davis HealthCare is the nation's #1 resource for Medicare audit defense and Medicare appeals.  Jackson Davis has assisted over 500 integrated health systems, physician practices, physical therapists, skilled nursing facilities, DME suppliers, home health agencies, hospices, inpatient rehabilitation facilities and health law firms nationwide in enhancing regulatory compliance and addressing perceived Medicare fraud & abuse challenges.

Comprised of board-certified physicians, nurses, billing compliance professionals and former hospital executives - Jackson Davis is the proven leader in applying Medicare coverage criteria to build winning Medicare appeals.  Jackson Davis provides Medicare appeals support to providers ranging in size from $10.0B multi-hospital health systems and major academic medical centers to home health agencies to individual physician practices.

Our experienced, industry-leading compliance & medical staff has provided crucial guidance & support to international healthcare consulting firms and publicly-traded clinical information technology organizations.  In addition, we authored the nation's only existing patent application for technology-driven, Health Information System (HIS) bill holds for a clinically conditioned patient charge structure.

Over the past 25 years, JDH has worked with providers to build the nation's best Medicare audit defense strategies and winning Medicare appeals:

2012 Medicare Self-Audit Templates - Are you looking to build a rock-solid internal audit & compliance program using Medicare coverage criteria as a foundation?  Have you been conditionally denied payment from a Medicare contractor and want to build winning appeals?  The 2012 Medicare self-audit templates are perfect for use by internal auditors and compliance professionals when reviewing home health episodes and building winning Medicare appeals.  These detailed, self-audit templates are now available for purchase by healthcare providers nationwide.

Medicare "Additional Documentation Request" Response (RAC auditor ADR response) - A provider's initial ADR response is THE most critical stage of the Medicare audit process.  Based upon our 25 years of Medicare audit defense experience, the vast majority of all cases can be won or lost at this crucial stage.  Jackson Davis professionals are experts at developing a cohesive and winning approach to responding to RAC auditor requests for documentation.  NO ONE will give you a better chance to address and eliminate additional Medicare audit threats.

Medicare Appeals (RAC appeals) - Jackson Davis professionals have worked with providers and attorneys nationwide to appeal 1,000s of Medicare overpayment issues.  JDH partners with providers and law firms to analyze, develop & build winning Medicare appeals cases.  Our board-certified physicians, legal nurse auditors and industry-leading compliance staff are unmatched in Medicare audit defense and the submission of winning Medicare appeals.  NO ONE will give you a better chance to succeed at your Medicare appeals.

CMS Compliance Advisory Services - Providers nationwide retain JDH for monthly audits, compliance advice or on a project-by-project basis.  Our staff is highly experienced and our knowledge and application of Medicare rules and regulations is unmatched in the industry.  We are true Medicare compliance geeks.  From our physicians to our nurses to our compliance reseach team, we are in your corner and available 24/7 for your CMS compliance needs.

Mock Medicare Program Integrity Audits (PI Audits) - JDH assists providers in completing proactive, medical records audits versus Medicare coverage criteria - Medicare Program Integrity audits (or Mock "PI Audits").  Each Medicare PI audit is based on documented, CMS payment criteria and Medicare coverage criteria for selected focus areas and may include a sampling of 10 - 500 patient encounters.  Each encounter is pre-screened and carefully selected based upon Medicare current or anticipated audit focus areas.

Jackson Davis audit defense and Medicare appeals clients are at the forefront of insuring compliance with all current Medicare coverage criteria and CMS evidence-based medical necessity requirements.  Over the past 25 years, our focus areas have included a wide range of CMS audits & CMS appeals services - Medicare RAC Audits, Medicare RAC Appeals, Medicare PSC Audits, Medicare ZPIC Audits, Medicaid Integrity Contractor Audits (MIC audits), Medicare fraud & abuse, Medicare Compliance Consulting, Medical Records / Clinical Documentation Development, Clinical Case Management, MS-DRG / ICD-9 Coding Application, Medicare Cost Report Development, Charge Master Evaluations, Claims & Denials Management Programs, Patient Service Revenue Cycle and Health Information Technology Support.

Based upon our extensive experience with CMS evidence-based standard of care outcomes, Medicare regulatory documentation and internal financial infrastructures, we are wholly unique in our ability to evaluate all aspects of the Medicare RAC audits & RAC appeals process.  We firmly believe in our unmatched qualifications to provide critical insight to relationships among required CMS clinical & billing payment criteria, medical necessity & process of care considerations and required CMS clinical documentation.

Jackson Davis HealthCare
3570 East 12th Avenue - Suite 200
Denver, Colorado  80206
(303) 586-5003

For questions regarding CMS efforts to stop Medicare fraud & abuse, Medicare appeals / "Mock" Medicare PI Audits, Medicare RAC audits, Medicare RAC appeals or other Medicare audit defense services, please contact us directly at (303) 586-5003 or support@jdhcare.com.