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Sarah Mendiola

Sarah Mendiola, LPN, CPC

Director of Clinical Services/Senior Attorney

Sarah Mendiola is a member of the legal team at Washington & West, LLC. Ms. Mendiola is a licensed nurse in the State of Maryland and a Certified Professional Coder (CPC). Ms. Mendiola’ work focuses on the appeal of claim denials by the Centers for Medicare and Medicaid (CMS) contractors, commercial insurers and the Maryland Medical Assistance Program. Ms. Mendiola has experience with both traditional Medicare denials and Medicare Advantage denials. She represents clients at Administrative Law Judge hearings and has obtained favorable results for claim denials from Zone Program Integrity Contractor (ZPIC) audits.

Ms. Mendiola came to Washington & West after many years of performing direct patient care as a Licensed Practical Nurse (LPN). Ms. Mendiola graduated from the practical nursing program at Walter Reed Army Medical Center and served on active duty in the United States Army for six years as a nurse. During that time, she supervised the paraprofessional staff in two units at a large Army medical center. After the completion of her military duty Ms. Mendiola was employed as an LPN at Mercy Medical Center. She also worked as a Law Clerk for the Baltimore City States Attorney’s Office.

Ms. Mendiola graduated magna cum laude from the University of Baltimore School of Law. She holds a Bachelor of Arts in jurisprudence from the University of Baltimore, where she graduated summa cum laude. Ms. Mendiola is admitted to the Maryland Bar and a member of the American Bar Association’s Health Law Section.

Education

J.D., University of Baltimore School of Law, Baltimore, MD
B.A., University of Baltimore, Baltimore, MD
LPN, U.S. Army Practical Nurse Course, Walter Reed Army Medical Center, Washington D.C.

Admitted to Practice

Maryland

Presentations/Publications

The Revenue Cycle Leader’s Role in Controlling Contract Profitability
Healthcare Financial Management Association (HFMA), Hudson Valley NY Chapter, Annual Institute, April 7, 2016

Medicare Advantage: Increasing Enrollments Demand Increased Provider Attention
Healthcare Financial Management Association (HFMA), Virginia-DC Chapter, March 24, 2016

Medicare Advantage: Increasing Enrollments Demand Increased Provider Attention
American Association of Healthcare Administrative Management (AAHAM), National, March 16, 2016 (Webinar).

Completing the Circle-Prevention and Appeal of Costly Coding Denials
AAPC, Baltimore East Chapter, October 22, 2015.

Navigating the Nebulous Path Through Exchange Plan Denials
American Association of Healthcare Administrative Management (AAHAM), Maryland Chapter, Annual Institute, September 15-17, 2015.

Defending Against ZPIC or other Potential Fraud Investigation by the OIG
American Association of Healthcare Administrative Management (AAHAM) and Healthcare Financial Management Association (HFMA), Minnesota Chapter, 2015 Joint Healthcare Summer Institute, August 12, 2015.

Completing the Circle: The Importance of CDIS Participation in the Denial Management Process
Association for Clinical Document Improvement (ACDIS), 2015 ACDIS Conference, May 19, 2015.

Defending Against a ZPIC or other Potential Fraud Investigation by the OIG
Healthcare Financial Management Association (HFMA), Iowa Chapter, Spring Meeting, April 16-17, 2015.

Medicare Settlement & Impact of AHA Suits
American Association of Healthcare Administrative Management (AAHAM), Maryland Chapter,  Legislative Updates Meeting, October 10, 2014.

Taking Charge of Your Revenue by Taking Charge of Your Managed Care Contract Terms
The Hospital and Healthsystem Association of Pennsylvania, August 13, 2014.

The Role of Patient Access in Denial Prevention and Intervention.
The American Association of Healthcare Administrative Management (AAHAM), Maryland Chapter, May 16, 2014.

White Paper: Zone (Program Integrity Contractor) Defense: Successfully Navigating ZPIC Audits
Sarah Mendiola, Esq., Linda Fotheringill, Esq., Washington & West, LLC