01
Common denial categories
The correct response depends on the payer, claim history, documentation, and filing requirements.
- Eligibility and coverage
- Authorization or referral
- Timely filing
- Duplicate claim
- Medical necessity
- Modifier, coding, and bundling
- Missing documentation
- Payer processing error
02
Our denial workflow
Identify, categorize, correct, appeal, track, and prevent. Each denial is documented with its cause, action, deadline, and outcome so repeat patterns can be addressed.
03
Appeals and reconsiderations
When appropriate, we coordinate the claim history and supporting information needed for corrected claims, reconsiderations, or appeals. Outcomes cannot be guaranteed and remain subject to payer rules.
04
Prevention through feedback
Recurring denials may point to benefit verification, authorization tracking, documentation, claim edits, enrollment, or posting problems. We translate those patterns into practical feedback for the practice.