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Quality & Practice

Toolkit for Physicians Challenging Denials in IRFs

AAPM&R is pleased to provide you with a link to a provider toolkit document that should be used as a reference by physiatrists and inpatient rehab facilities in preparing for hearings before administrative law judges (ALJs) resulting from audits by Fiscal Intermediaries or as appropriate. The detailed memo, summary checklist and a series of attachments should assist physiatrists who practice in the inpatient rehab setting in challenging denials of inpatient rehab claims based on medical necessity, or theories related to less intensive setting, lack of documentation, etc. The documents were prepared by the AAPM&R’s legal counsel, Powers, Pyles, Sutter & Verville, PC.

  • Download the provider toolkit document
    Note: 3876 KB in size. Depending on the speed of your connection, you may need up to 90 minutes to download. Consider downloading at non-peak hours for best results.
  • To have a copy of the provider toolkit mailed to you, please contact us at 847.737.6000 or by e-mail at info@aapmr.org.