Denial Management & Appeals
We investigate every unpaid claim and fight to recover the revenue you've earned.
What This Service Does
Our Denial Management service focuses exclusively on overturning rejected claims. We identify the root cause of every denial, correct the error, and submit comprehensive appeals to payers.
Why It Matters to Your Money
Insurers often count on providers walking away from small or complex denials. This 'leakage' can amount to 10-20% of your total revenue. We plug that leak.
Common Problems We Fix
- Large backlog of unpaid claims
- No time to sit on hold with payers
- Complex denials requiring medical necessity arguments
- Write-offs increasing year over year
How We Do It Better
We sort denials by root cause (coding, registration, credentialing) and tackle them in batches for efficiency. We track payer trends to prevent future denials.
Root Cause Analysis
Categorizing why claims are failing.
Correction & Re-submission
Fixing simple errors and resubmitting.
Appeals
Writing formal arguments for medical necessity.
Prevention
Feedback loop to front-desk and doctors.
Is This Right for Your Practice?
YES, If...
- You have a high volume of aged A/R
- You maintain high write-offs
- You don't have dedicated staff for appeals
NO, If...
- You collect 99% of what you bill
- You act as a cash-only practice
Still not sure? Let's talk about your specific needs.