Services

FHAS works with a diverse client base ranging from national health plans to state government agencies to pharmacy benefit managers to providers in private medical practice. We recognize that every client and every contract is unique, and we regularly work with new and returning clients to craft agreements specific to their business need.

We view the following as simply a menu of services, and welcome the opportunity to discuss a customized business processing solution through which our experienced team of legal and medical professionals can best serve you.

Learn more about Independent Dispute Resolution Services for the No Surprises Act.

HEALTHCARE SERVICES

The FHAS team has in-depth knowledge of government health care programs and commercial health plans.

We are industry leaders regarding inpatient and outpatient hospital and ancillary services, prescription medication, durable medical equipment (DME), and Recovery Auditor Contractor (RAC) appeals.

Our healthcare services include:

Disability Claims Review
Health Plan Coverage Decisions
Independent Medical Reviews
Medical Necessity & Payment Accuracy Reviews
Medicare/Medicaid Claim Coverage Determinations
Peer Review
Pre-Admission Certification Reviews
Prescription Benefit Reviews
Prior Authorizations
Quality of Care Reviews/Malpractice Evaluations
Retrospective Claims Audits
URAC-Certified IRO for Internal & External Reviews, including professional services for Corporate Integrity Agreements (CIAs)
Utilization Review - Care Management

LEGAL SUPPORT SERVICES

FHAS legal and medical experts utilize their knowledge and analytical skills to perform complex audits of contracts and transactional histories for our clients to determine whether contracts and transactions were properly executed or whether non-compliance and deficiencies exists. Our team can furnish administrative litigation support by reviewing documents, making determinations on whether files are confidential, and drafting basic templates and forms for your group.

Administrative Law Judge/Hearing Officer Services
Adverse Action Adjudications
Document Workflow Organization Outsourcing
Litigation Support
Mediation and Arbitration
Tort Medical Review and Administrative Support Services
URAC-Certified IRO for Internal & External Reviews, including professional services for Corporate Integrity Agreements (CIAs)

GOVERNMENT BENEFIT ADMINISTRATION

FHAS has furnished government benefit administration and administrative services as either a prime contractor or subcontractor to:

Federal

U.S. Department of Health and Human Services
- Centers for Medicare & Medicaid Services
- Health Resources and Services Administration
- Indian Health Service
U.S. Department of Homeland Security
U.S. Department of Justice
U.S. Department of Veterans Affairs

State

Pennsylvania
- Department of Human Services
- Office of General Counsel
- Office of the Attorney General
Alaska
- Department of Administration
- Department of Commerce, Community, & Economic Development
Delaware
- Department of Health & Social Services
Idaho
- Department of Insurance
Indiana
- Department of Insurance
Minnesota
- Hennepin County
Montana
- Commissioner of Securities & Insurance
Nebraska
- Department of Insurance
Nevada
- Division of Insurance (External Review and Workers Compensation)
North Carolina
- Department of Insurance
- Department of Health & Human Services
North Dakota
- Insurance Department
Oklahoma
- Community Care Managed Health Plans of Oklahoma
Oregon
- Department of Consumer & Business Services and the Department of Financial Regulation
Tennessee
- Department of Commerce & Insurance
Utah
- Insurance Department, Life and Health Division
Washington
- Office of Insurance Commissioner
Wyoming
- Department of Insurance

Healthcare Services

Legal Support Services

Government Benefit Administration