Denial Management Services
RevClinic360 provides aggressive denial management services that turn rejected claims into recovered revenue. Our dedicated denial management team performs root-cause analysis on every denial, files timely and well-documented appeals, and implements systemic prevention strategies to stop denials before they happen.
Most practices write off 3-5% of their gross charges to preventable denials. Our denial management program targets every denied claim with a structured workflow: categorize by reason code, identify the root cause, prepare supporting documentation, file appeals within payer deadlines, and track outcomes to prevent recurrence. We maintain an appeal overturn rate above 65% and provide monthly trending reports so you can see exactly where denials originate and how they are being resolved.
- Root-cause analysis on every denial with categorization by payer, reason code, and provider.
- Timely appeal filing with comprehensive supporting documentation and clinical narratives.
- Monthly denial trend reports with actionable prevention recommendations to reduce future denials.
Most practices write off 3-5% of their gross charges to preventable denials. Our denial management program targets every denied claim with a structured workflow: categorize by reason code, identify th...
Frequently Asked Question
We maintain an appeal overturn rate above 65%, meaning we successfully recover payment on the majority of denied claims we appeal. Many practices see even higher rates after we address systemic issues.
We file appeals within 48-72 hours of denial identification, well within payer deadlines. Timely filing is critical to successful denial recovery.
Yes. We manage retro-authorization requests, peer-to-peer reviews, and all levels of appeal for authorization-related denials, including external review when appropriate.
We handle all denial types including eligibility, authorization, coding, medical necessity, timely filing, duplicate claim, and coordination of benefits denials.
We analyze denial patterns monthly, identify systemic root causes, and implement targeted interventions such as eligibility workflow changes, coding education, and authorization tracking improvements.