Megann Denefrio, JD | Managing Attorney
Megann Denefrio oversees resolution of complex legal and regulatory issues related to the healthcare industry and hospital revenue cycle management for multiple large hospital systems. In addition to managing a team of attorneys and maintaining her own case load, Ms. Denefrio regularly assists with projects to identify root cause denials and payer trends for SHP’s clients and works closely with payer representatives to achieve resolution or settlement of wrongfully denied claims. Ms. Denefrio also has extensive experience coordinating with hospitals, physicians and patients to address complex experimental and investigational denials through the internal and external appeal process. Her industry experience includes Medicare regulations and appeals processes, RAC audits, experimental and investigational denials, medical necessity denials, DRG downgrades, and pre-arbitration/litigation claim review.
Prior to joining the SHP management team, Ms. Denefrio was an Attorney Advisor for an Administrative Law Judge (“ALJ”) with the Office of Medicare Hearings and Appeals (“OMHA”) in Miami, Florida. While at OMHA, Ms. Denefrio managed a docket of over 3000 cases involving services such as DME, inpatient care, hospice, Part B outpatient services, SNF, home health, IRF and entitlement. She provided legal advice and assistance to the ALJs reviewing third level appeals for denied Medicare services, and performed extensive research to identify legal issues related to Medicare coverage of services, reviewed medical records and drafted legal memoranda in preparation for administrative law hearings.
Education and Credentials:
Juris Doctor, Cum Laude, St. Thomas University School of Law, Miami
Editor, St. Thomas Law Review
B.A., Political Science, Cum Laude, Union College, New York
State Bar Member, Florida and New York
Member, Florida Bar Health Law Section