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Home / Revenue Cycle Management / Denial Management
Revenue cycle management
We find out why claims are denied, fix and appeal them quickly, and stop the same denials from happening again.
Good denial management finds out why claims are being denied, fixes the cause and gets you paid sooner.
A denied claim is one the payer has reviewed and refused to pay. Each denial is revenue that is late or at risk of being lost. Winning it back means studying the reason, correcting the problem and submitting an appeal.
We fix incorrect codes, gather supporting documents, appeal authorization denials and more, and we double-check every claim before it goes back to the payer.
Every denial and underpayment is flagged from ERAs and EOBs the day it arrives.
We find the real cause: eligibility, authorization, coding, documentation or payer error.
Claims are corrected and resubmitted, or appealed with the right documentation, before appeal deadlines.
Denial trends are reported to you with the fix, so the same denials stop coming back.
The most common causes are eligibility and coverage problems, missing prior authorizations, coding or modifier errors, duplicate claims, missing documentation and timely filing limits.
It depends on the payer. Many commercial payers allow 60 to 180 days, and Medicare redeterminations must be filed within 120 days of the initial decision. We track every deadline for you.
Yes. We can review and work older denied claims that are still inside the appeal window as part of an AR recovery project.
Yes. Your reports show denials by reason, payer and provider, with the actions taken and what we changed to prevent them.
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