FHAS is a certified small business and URAC-accredited Independent Review Organization (IRO) with Health Utilization Management (HUM) accreditation. For more than 30 years, we have delivered clinician-led, technology-enabled medical review services to federal agencies, state programs, and commercial clients. Our reviews help identify and prevent fraud, waste, and abuse while meeting the stringent standards of Medicare, Medicaid, and other federal programs through audit-ready determinations and evidence-based clinical decisions. Service Offerings: * Medical Review & Utilization Management - URAC-accredited Health Utilization Management (HUM) services, including prior authorization, medical necessity determinations, and comprehensive coding and billing audits across all medical specialties * Appeals Management – End-to-end management of 1st-, 2nd-, and 3rd-level internal and external appeals conducted by licensed physicians and certified nurse coders * Provider Outreach & Education – Implementation of CMS Targeted Probe & Educate (TPE) program with personalized provider engagement to reduce coding errors and strengthen compliance * Claims Audit & Review - Comprehensive post-payment audits, coverage determinations, and bill review services designed to safeguard program integrity and ensure proper payment accuracy * Legal Adjudication Services - Administrative law representation and healthcare attorney support for coverage determinations and dispute resolution * Independent Dispute Resolution (IDR) - Certified Independent Dispute Resolution Entity (IDRE) under the No Surprises Act, providing impartial arbitration for payment disputes between out-of-network providers and health plans through clinically informed, tech-enabled, and fully compliant processes * Consulting – Industry-recognized subject matter experts in medical record review and prior authorization offering advisory services to technology companies and government contractors. Performance & Quality FHAS delivers measurable value across federal and state programs, maintaining a 100% on-time completion rate for millions of adjudicated medical claim reviews. Our distinguished credentials, including three URAC accreditations (Comprehensive IRO, HUM and IDR), ISO 9001:2015 certification, and consistently outstanding CPARS ratings reflect, demonstrate our unwavering commitment to quality, compliance, and client trust.