August 4, 2026
The settlement resolves allegations from 2020 to 2023 that the company submitted HCCs that were “not clinically valid” or not supported by medical records or treatment plans.
This article was originally published on Fierce Healthcare.
The nation's only association for healthcare denial & appeal management
Appeal advocacy.
Appeal training.
Appeal education.
The industry's trusted authority on overturning denials and payer audits — equipping providers with the expertise, resources, and community to challenge unfair practices, recover rightful revenue, and drive lasting change in healthcare reimbursement.
› Knowledge Center · 119 resources indexed
✓ 50 state-by-state legal snippets available
✓ Filtered by denial type, payer, clinical scenario
› Next webinar
✓ Hold the Level and Hold the Bed: Winning Behavioral Health and Skilled Nursing Facility Denials · Wed · Aug 26
› Membership
◐ 1840 active members
& growing
› Ask the experts
✓ Q&A open · avg response < 24h · members only
› _
01 Webinars
From the appeals front line.
02 What members get
Four pillars of appeal expertise. Built by appeal professionals, for appeal professionals.
A national voice for appeal professionals.
AHDAM speaks for the people doing the work — pushing back on payer practices that erode reimbursement, surfacing patterns across hospitals, and partnering with policy bodies to drive change.
- Industry policy briefs & comments
- Payer accountability through pattern data
- Partnerships with Hyve Health, PayerWatch
- National conferences & events
focuspayer_accountability
partnershyve · payerwatch
forumspolicy + industry
since2005
The Knowledge Center — every resource in one place.
119+ tip sheets, templates, policies, and 50 state-by-state legal snippets — searchable by denial type, payer, and clinical scenario. Two decades of practitioner-tested guidance.
- 119+ resources indexed
- 50 legal snippets state-by-state
- Policy & procedure library
- Appeal letter templates
Filter:
Payer:
State:
Results:
Access:
38 practitioner-led webinars a year.
Live sessions and on-demand recordings from the appeal professionals who've done it. Clinical validation. DRG downgrades. Prior auth strategy. Ask-the-experts Q&A built in.
- 38 webinars annually
- CME eligible sessions
- Live Q&A with appeal experts
- On-demand recording library
Clinical Validation in 2026 ✓ Wed Mar 27
Fighting Readmission Denials ✓ on-demand
MA Two-Midnight Rule in 2026 ✓ on-demand
Peer-to-Peer Strategy ● next week
2026 OIG Findings ○ upcoming
Become a certified appeal professional.
AHDAM Appeal Management Certification — the credential that proves you can do this work. Curriculum, exam, continuing education, all in one pathway.
- Formal credential program
- Curriculum + exam pathway
- Continuing education tracking
- Team certification available
M1Enroll
M2Coursework
M3Practicum
M4Exam
M5Certified
AHDAM Partnerships
AHDAM is proud to announce a strategic partnership with Hyve Health. Our shared mission is to strengthen the healthcare community's ability to prevent manage, and overturn insurance denials.
HYVE brings advanced analytics and tranparency tools, like the Payer Vitality Scorecard™, empowering providers to track and respond to shifting payer behavior.
Partners →
PayerWatch is on a mission to ensure every hospital in the U.S. is fully capable of defending themselves against egregious payer behavior. That's a mission we at AHDAM can get behind!
Through sophisticated software and world-class appeal solutions PayerWatch is holding payers accountable and protecting provider revenue like no one else in healthcare today.
Partners →03 What members are saying
Practitioners on practitioner-led education.
AHDAM is the only place I've found where the appeal letters, the legal precedent, and the people who've actually overturned these denials all live in one room.
Sarah Reynolds, RN, BSN
Director of Denials · Regional Health System
I've written hospital appeals for 15 years. By far the most practical training I've ever taken — clinically grounded, legally informed, and immediately useful Monday morning.
Physician Advisor
Academic Medical Center
The Minnesota ACDIS chapter learned an enormous amount. Conversational, candid, and packed with strategy we can deploy that day.
Minnesota ACDIS Chapter
Regional Member Organization
04 The leadership
An association built by the people doing the work.
BM
Founded AHDAM to put practitioner intelligence in every appeal professional's hands. Two decades in healthcare denial & appeal management.
KS
Senior Fellow in Hospital Medicine. Leads clinical & physician-advisor programming, peer-to-peer strategy, and the certification curriculum.
BD
AHDAM's board brings together healthcare attorneys, physician advisors, and revenue cycle leaders from health systems nationwide.
Join the people overturning denials.
Become a member, get certified, or ask the appeal experts — three ways into the AHDAM community.