How we work denials
Each denial is categorized by its CARC/RARC reason code and routed to the right fix.
- Eligibility and coverage denials: verify and rebill or bill the correct payer
- Coding and modifier denials: correct and resubmit
- Medical necessity denials: gather documentation and appeal
- Authorization denials: pursue retro-authorization where the payer allows it
- Timely filing: proof-of-timely-filing submission where available
How to reduce medical claim denials
Most denials are preventable at the front end. Our monthly denial report shows denial reasons by payer and provider so we can fix the upstream cause — usually eligibility, authorization, or documentation.
Denial Management by specialty
See how we apply denial management to specialty-specific rules:
Frequently asked questions
Will you eliminate all denials?
No billing company can honestly promise that. We work every denial and reduce preventable ones by fixing root causes.
Do you handle old denials?
Yes, as long as the payer's appeal window is still open.