Background

Expert Denial Management Services

Recover lost revenue and prevent future claim denials with our comprehensive denial management solutions.

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Transform Denials into Revenue

Claim denials present one of the most significant revenue cycle challenges healthcare practices face today. Each denied claim represents potential revenue that requires additional resources to recover. Our denial management approach goes beyond simple appeals to address the underlying causes systematically.

We've developed specialized techniques that help medical practices not just recover funds but fundamentally strengthen their revenue cycle processes. By implementing strategic improvements and staff education, we help create sustainable systems that minimize future denials while maximizing appropriate reimbursement.

85%

Recovery Rate

65%

Reduction in Denials

48h

Average Resolution Time

Denial Management Visualization

Common Denial Reasons We Address

Understanding the root causes of denials is the first step toward prevention

Eligibility Issues

Coverage termination, inactive policies, or non-covered services that lead to claim denials.

Timely Filing

Claims submitted after payer-specific deadlines resulting in automatic denials.

Authorization Issues

Lack of pre-authorization or referral requirements not being met before services.

Coding Errors

Incorrect CPT, ICD-10, or modifier usage that leads to claim rejection.

Documentation Issues

Insufficient medical documentation to support the medical necessity of services.

Data Entry Errors

Incorrect patient information, policy numbers, or other data inaccuracies.

Our Denial Management Approach

A systematic process to identify, address, and prevent claim denials

Comprehensive Denial Analysis

We perform a detailed analysis of all denied claims to identify patterns, root causes, and systemic issues affecting your revenue cycle.

Customized Action Plan

Based on our analysis, we develop a tailored strategy to address your specific denial challenges and implement corrective measures.

Proactive Appeal Management

Our team handles the entire appeals process, from preparing necessary documentation to following up with payers until resolution.

Performance Monitoring

We continuously track denial rates, appeal success rates, and other key metrics to measure improvement and identify new trends.

Staff Education

We provide training to your front-end staff on common denial triggers and how to prevent them at the point of service.

Preventive Measures

We implement systems and processes to prevent common denials before they occur, reducing future write-offs.

Proven Results

Our denial management services deliver measurable outcomes for practices

25-40%

Average reduction in denial rates for our clients

80-90%

Recovery rate on appealed claims

45%

Faster resolution time compared to in-house teams

$2.5M+

Recovered revenue for clients in the past year

Real Practice Improvements

One multi-specialty practice we worked with was struggling with a 18% denial rate that was crippling their cash flow. After implementing our denial management system, they reduced denials to just 6% within six months. This transformation recovered over $380,000 in previously lost revenue and established processes that prevented future losses.

Another client, a busy orthopedic surgery center, faced persistent authorization denials that delayed patient care and payment. Our team identified the specific breakdown points in their authorization process and implemented a verification protocol that reduced authorization-related denials by 72% in the first quarter.

Transparent Pricing

Flexible options tailored to your practice's needs

How do you charge for denial management services?

We offer flexible pricing models based on your practice's specific needs and denial volume:

Percentage Model

Pay only for results with a percentage of recovered revenue

Ideal for: Practices with high denial volumes

Per Claim Model

Flat fee per claim appealed, regardless of recovery amount

Ideal for: Predictable budgeting

Retainer Model

Monthly fixed fee for comprehensive denial management

Ideal for: Ongoing denial prevention

Frequently Asked Questions

Get answers to common questions about our denial management services

We can typically begin within 48 hours of engagement. The first step is gaining access to your practice management system and denials report. Our team will then perform an initial assessment and present a plan of action within the first week.

Our average success rate for overturning denials is 80-90%, significantly higher than the industry average. Success varies by denial reason and payer, with technical denials having higher overturn rates than medical necessity denials.

Yes, we have experience working with practices across all medical specialties. Our team includes specialists familiar with the unique billing requirements and common denial reasons for each specialty, from primary care to surgical subspecialties.

We offer flexible pricing models based on your practice's needs. Options include percentage of recovered revenue, flat fee per claim, or monthly retainer arrangements. We'll recommend the most cost-effective approach after assessing your denial volume and patterns.

To begin, we need access to your practice management system, denial reports, and any relevant documentation. We'll also want to understand your current processes for handling denials and any specific challenges you're facing.

Ready to Reduce Denials and Increase Revenue?

Our denial management experts are ready to help you recover lost revenue and prevent future claim denials.

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Medical Billing Assistant

Hello! I'm your medical billing assistant. How can I help you today?
I can answer questions about:
• Medical coding CPT, ICD-10
• Claim submission
• Denial management
• Revenue cycle optimization
• AccuMed BPO services