Denials and appeals
Every denial worked, appealed with the documentation attached, and traced back to whatever caused it so the same one stops arriving.
What it covers
- Denials triaged by payer, reason, and value
- Appeals written and filed inside the payer's window
- Supporting documentation gathered and attached
- Underpayments identified against your contracted rates
- Root causes fixed upstream in intake or coding
- Denial reasons reported monthly so patterns are visible
How it works
Work the queue
Every denial is triaged rather than aged out, sorted by what it is worth and how long there is to act.
Appeal properly
Appeals are written with the documentation the payer asked for and filed inside the window, not after it.
Fix it upstream
Each denial is traced back to intake, coding, or authorization, so the cause is corrected rather than re-worked.
Who it is for
Practices writing off denials past a certain age because there is never time to work them properly.
Questions we get
Will you work denials we have already written off?
Where the payer's window is still open, yes. Triaging what is still recoverable in the existing backlog is part of taking over.
How do you stop the same denial recurring?
Every denial is traced back to intake, coding or authorization, and the cause is corrected there. Re-working the same denial every month is not a process.
Do you check for underpayments as well?
Yes. Payments are checked against your contracted rates, because an underpaid claim is quieter than a denied one and just as expensive.