Medical Billing Denials

A critical step in the billing process is resubmitting any claims that are not received by the insurance company or need to be corrected and resubmitted. All submissions are confirmed with the insurance company within 10 days to prevent any denials for untimely filing. Claims automatically pop up in user buckets if they are not paid within allowable timeframes.

Denials and appeals management services

Access our expertise in analyzing payer adjustment codes from remittance advice, including case management and utilization review, to facilitate successful appeal of denied claims.

Payer audit services

Leverage our expertise in appealing Medicare notifications to rescind payments via the Medicare Recovery Audit Contract Program (RAC), and to address other commercial and government payer audits.

Ongoing system edit-and-workflow maintenance

Depend on our experts to keep your team abreast of regulatory changes. We review and implement payer bulletins and educate your staff via tutorials—all to facilitate a proactive approach to denials management.

Detailed denials management process reporting

Gain valuable trending insights as well as specific recommendations for documentation, edit improvements, claims management, and process improvements to address the root causes of denials and to increase clean claims.