Recovery services, in full.
Denial Root Cause Analysis
Every denial is categorized by type, payor, and reason code — then analyzed for systemic patterns. The findings feed directly back into upstream front-end and mid-cycle processes. We don't just fix denials; we prevent the next generation of them.
Appeals & Reconsiderations
Timely, well-documented appeals with supporting clinical documentation. Peer-to-peer coordination for complex medical necessity denials. Level 1, Level 2, and external review pathways navigated by our denial specialists.
AR Aging Management
Systematic follow-up buckets at 30/60/90/120+ days. Nothing ages out without a documented action. Payor-specific follow-up scripts, portal access, and phone escalation protocols keep claims moving. Claims over 90 days represent less than 4% of our managed portfolio.
Denial Trend Reporting
Monthly denial trend reports identify systemic issues by payor, code, provider, and facility. We present actionable findings in your performance review so the root cause — not just the symptom — gets fixed permanently.