Medical Claim Denial Management Services
Denials aren't write-offs — they're recoverable revenue. Our dedicated denial team triages every rejection within 48 hours, fixes the root cause, and feeds prevention rules back into your front-end process.
- Avg. denial rate
- 1.8%
- Turnaround SLA
- 48h
- Denials overturned
- 72%
Everything handled, nothing handed back.
48-hour triage SLA
Every denial reviewed and routed within two business days.
Root-cause analysis
Categorized by payer, code, and cause to find the pattern.
Appeals & rework
Corrected claims and formal appeals filed with documentation.
Prevention rules
Front-end edits updated so the same denial never repeats.
Payer escalation
Systematic follow-up on stalled or underpaid claims.
Denial trend reporting
Monthly visibility into denial rate by category.
Our denial management process
- 01
Triage
Every denial categorized by root cause within one business day.
- 02
Correct
Claims corrected and resubmitted, or appealed with documentation.
- 03
Escalate
Stalled appeals escalated to payer reps and, when needed, external review.
- 04
Prevent
Root-cause fixes fed back into front-end and coding workflows.
Frequently asked questions
Every denial is triaged within 48 hours under our turnaround SLA. Each one is categorized by root cause, then corrected and resubmitted or formally appealed with documentation. Stalled appeals are escalated to payer representatives and, when needed, external review. You get monthly visibility into denial trends by category.
Our denial management service reports an average denial rate of 1.8% and 72% of denials overturned, with a 48-hour turnaround SLA. We treat denials as recoverable revenue, not write-offs, and track every claim through correction, appeal or escalation until it is resolved.
We analyze denials by payer, code and cause to find the pattern, then feed prevention rules back into your front-end and coding workflows. Monthly denial trend reporting shows your denial rate by category, so you can see repeat problems shrinking over time.
Yes. Our payer escalation work includes systematic follow-up on stalled or underpaid claims, not just outright denials. Corrected claims and formal appeals are filed with supporting documentation, and unresolved cases are escalated to payer representatives so money owed to your practice is pursued.