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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 are one of the biggest challenges in medical billing, costing practices millions in lost revenue annually. Our denial management services are designed to not only recover denied claims but also prevent future denials through systematic analysis and process improvement.

With our expertise in denial management, we help practices identify root causes, implement corrective actions, and establish proactive measures to minimize denials and maximize revenue.

85%

Recovery Rate

65%

Reduction in Denials

48h

Average Resolution Time

Denial Management Visualization

Precision Payment Posting for Optimal Revenue Cycle Management

Accurate payment posting forms the foundation of effective denial management and revenue integrity

Our meticulous payment posting service ensures every dollar received is properly accounted for, reconciled, and applied to patient accounts with precision. We understand that payment posting errors often cascade into denied claims, creating unnecessary rework and revenue leakage.

Through our systematic approach, we capture and record payments from all sources including insurance payers, patient payments, and third-party reimbursements. Our team cross-references each payment with the original claim, identifying discrepancies, underpayments, and contractual adjustments that require immediate attention.

Our Payment Posting Process Includes:

  • Daily processing of ERA/EOB documents with 99.97% accuracy
  • Identification of underpayments against contracted rates
  • Reconciliation of patient responsibility amounts
  • Application of appropriate adjustments and write-offs
  • Timely follow-up on payment discrepancies

Payment Posting Accuracy Metrics

ERA Processing Accuracy 99.97%
Underpayment Identification Rate 94.5%
Payment Posting Timeliness Within 24 hours
Discrepancy Resolution Rate 87.3%

Preventing Denials Through Accurate Payment Posting

Proper payment posting creates a clean accounts receivable foundation that significantly reduces denial rates. When payments are posted correctly the first time, it eliminates downstream errors that trigger denials. Our team identifies patterns of underpayments and systematic errors that often go unnoticed, addressing them before they create larger revenue cycle problems.

Advanced Technology Integration

We utilize advanced payment posting technology that automates data extraction from ERAs and EOBs, reducing manual entry errors by 72%. Our systems automatically flag discrepancies, underpayments, and non-contractual adjustments for immediate review. This technology-driven approach ensures consistent accuracy while freeing your staff to focus on patient care rather than administrative tasks.

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

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