Denials Management Services Recover Lost Revenue & Faster
At RevenueCycle Pros, our comprehensive Denials Management Services are designed to reduce claim denials, recover unpaid revenue, and prevent future disruptions in cash flow. Our experts identify root causes, appeal denials efficiently, and implement proactive solutions to help your practice get paid—fully and faster.
What is Denials Management?
Denials management is the process of investigating, correcting, and appealing denied or underpaid insurance claims. It’s a crucial part of revenue cycle management (RCM) that directly impacts a provider’s financial health.
Insurance companies deny claims for a variety of reasons—ranging from coding errors to missing documentation and eligibility issues. Without a structured process, these denials can accumulate and severely affect cash flow.
Why Denials Management is Critical
Did you know that 15–25% of all claims are denied or rejected on first submission? And yet, up to 65% of these denials are never reworked?
Unmanaged denials lead to
- Lost revenue
- Compliance risks
- Patient dissatisfaction
- Increased administrative burden
At RevenueCycle Pros, we don’t let money slip through the cracks. We recover what’s owed—and prevent future denials with data-driven insights.
Our Denials Management Process
We follow a proven, proactive process to handle denied claims effectively and prevent them from recurring
Claim Analysis & Denial Identification
We begin by identifying denied and underpaid claims from your accounts receivable (A/R). We categorize denials based on reasons (e.g., coding errors, eligibility issues, timely filing) and payers
Root Cause Investigation
Our specialists conduct a deep-dive analysis to uncover the real reason behind each denial. We examine:
- Claim history
- Coding accuracy
- Payer policy compliance
- Supporting documentation
Corrective Action & Claim Resubmission
Once identified, we correct the issues—whether it’s an ICD-10 coding error, modifier omission, or documentation gap—and resubmit the claim promptly within payer guidelines.
We also handle:
- Coordination of benefits (COB)
- Missing info requests
- Medicare secondary payer (MSP) claims
Appeals & Reconsiderations
For complex denials, we draft and submit formal appeals with supporting clinical documentation, adhering to payer-specific requirements.
Our team has a high success rate with:
- Medical necessity appeals
- Authorization-related disputes
- Level I and II payer appeals
Prevention & Denial Trend Reporting
We don’t just fix denials—we stop them from happening again. Our team provides:
- Monthly denial trend reports
- Feedback to coders and front desk teams
- Training suggestions and process changes
- Ongoing payer rule monitoring
Who Needs Denials Management?
Denials Management is essential for
- Physician practices
- Multi-specialty groups
- Surgery centers (ASCs)
- Behavioral health clinics
- Telemedicine providers
Benefits of Our Denials Management Services
- Faster recovery of denied and underpaid claims
- Reduced write-offs and revenue leakage
- Lower denial rates over time
- Improved compliance and documentation practices
- Transparent communication with real-time tracking
Technologies & Integrations
We work seamlessly with your existing billing software or EHR (e.g., Kareo, Athena, DrChrono, AdvancedMD, NextGen) to extract denial data, process rework, and post outcomes—securely and efficiently.
Why Choose RevenueCycle Pros?
- Specialized team of denial resolution experts
- Decades of payer experience and appeals handling
- HIPAA-compliant, secure claim processing
- Real-time dashboards and reporting
- Dedicated account manager for ongoing support
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Start Recovering Revenue Today
Don’t let denied claims slow your practice down. Contact RevenueCycle Pros today for a free denial audit or a customized recovery plan tailored to your specialty and payer mix.