Denials & Denial Management

Our expertise includes managing denials for following reasons:

  • Authorization Issues
  • Referral Issues
  • Medical Necessity and Medical Records requests
  • Non-Participation with Insurance Network
  • Terminated Insurance
  • Coordination of benefits
  • Inclusive Procedures
  • Partial Payments
  • Out-of-network claim status and deductibles
  • EDI Rejections
  • Letter of Protection from Attorney cases
  • No status and No claim on File
  • Workers’ Compensation
  • PIP cases

Our Denials and Denial Management service is designed to increase Revenue Collection for Physician offices

Obtaining an accurate reflection of denials for a multispecialty practice can be challenging. The denial rate for a multispecialty group practice may be 5 percent, but that overall rate may include a 20 percent denial rate for obstetrics and a rate of 1 percent for family practice.

You need to look at denial rates by type of specialty. We segregate denial rates for primary care [family practice and internal medicine] from those for specialties that have potentially higher denial rates.