What is a realistic denial rate target?

The national average denial rate is 19%. Top-performing billing operations achieve below 5%. We target under 5% within 90 days for new clients.

How do you handle complex clinical denials?

We prepare detailed clinical appeal letters citing the specific payer policy, CPT/ICD code guidance, and supporting documentation. For multi-level appeals, we escalate to external review when appropriate.

Can you work denials from my current software?

Yes. We can work denial queues in your existing PM system or our platform — whichever is more efficient for your operation.

Denial Management

Denial Management & Revenue Recovery

Root-cause analysis. Pattern elimination. Revenue recovery.

We don't just work denials — we eliminate their source. Our denial management process combines data analysis, payer-specific expertise, and aggressive appeals to recover lost revenue and prevent future rejections.

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Problems We Solve

Denial rate above 10% eating into collections

No systematic process for tracking or working denials

Appeals filed without proper supporting documentation

Same errors repeating month after month

Payer-specific rule changes causing spikes in rejections

What's Included

Denial categorization and root-cause analysis

Technical and clinical appeal preparation

Payer-specific appeal strategies

Historical denial pattern analysis

Preventive rule updates to billing workflow

Denial tracking dashboard with trend analysis

Monthly denial performance review

Expected Outcomes

Denial rate reduced below 5% within 90 days

90%+ appeal success rate on valid claims

Pattern-based prevention of repeat denials

Full denial reporting by payer and reason code

Automatic billing rule updates to prevent recurrence

Frequently asked questions.

Ready to get started?

Free audit.
48-hour findings.

We review your denial management situation and deliver written findings. No commitment.

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305 394-8641

Mon–Fri 9:00 AM – 5:00 PM EST

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