Denial Management
Denial management that recovers revenue and prevents repeats
We work every denial to resolution and do root-cause analysis on each one. Appeals are written by specialists who know payer policy, and the patterns we find feed back into front-end fixes.
What you get
Why practices hand denial management to us
Every denial worked
No denial is written off without review, correction, and appeal where justified.
Root-cause fixes
Denials are categorized by cause, payer, and provider so they don't recur.
Expert appeals
Well-documented appeals that cite payer policy and medical necessity.
Trend reporting
Monthly denial trend reports with prevention recommendations.
How it works
Our process, step by step
- Step 1
Capture
Denials are captured from ERAs and correspondence within 24 hours.
- Step 2
Categorize
Each denial is classified by CARC/RARC code, payer, and root cause.
- Step 3
Resolve
Corrected claims and appeals are submitted within payer timely-filing windows.
- Step 4
Prevent
Front-end rules and staff training close the gaps behind each pattern.
Questions
Common questions about denial management
Yes. We can run a denial recovery project on historical denials that are still within appeal windows.
Industry studies commonly put denial rates between 10 and 15 percent. Our current client average is 4.8%.
Find out what your billing is really costing you
Send us 90 days of claims data and we'll show you where revenue is slipping through, how much is recoverable, and what we would fix first. It's free and there's no obligation.
We sign a BAA before any patient data changes hands.
