Denials worked to appeal, not written off.
Denial management is finding why claims are denied, fixing the cause upstream, and appealing the denials worth contesting with the documentation and payer policy that support payment. We focus on procedural denials: modifiers, bundling, medical necessity and authorization.
From denial code to deposited payment.
Every denial is sorted by cause, value and deadline before anyone writes a letter.
Triage
Group denials by CARC/RARC code, payer, CPT and modifier; rank by dollar value and appeal deadline.
Fix and resubmit
Correct coding or demographic errors and resubmit corrected claims where an appeal isn't needed.
Appeal
Write appeals that cite the op note, the payer's own policy and CPT/NCCI rules; escalate to peer-to-peer or external review when warranted.
Strategy backed by experienced specialists.
Strategy & Direct Client Partnership led by Rohit Pandey, backed by a dedicated team of credentialed medical coders (AAPC/AHIMA) and seasoned AR follow-up specialists.
What you see each week
- Denials received by reason
- Appeals filed, won and pending
- Recovered dollars
- Root causes fixed upstream
Denial management: common questions
Which denials do you appeal?
Those with a realistic chance and value worth the effort, prioritized by appeal deadline. Coding errors we correct and resubmit.
Do you handle peer-to-peer reviews?
We prepare the case and documentation; the physician joins the call where the payer requires it.
How do you stop the same denial repeating?
Each denial is traced to its cause (coding, documentation, authorization or payer behavior) and the fix is applied before the next claim goes out.
10 minutes. One screen. Your numbers.
A short Google Meet with Rohit to look at where your revenue stalls and whether contingency recovery makes sense for your practice. No software change, nothing to pay up front.