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Denial Analysis in Medical Billing Service | CREDENSE Denial Specialists in USA
The denial experts at CREDENSE will assess your procedure denial, assess its appeal potential, handle the necessary paperwork to facilitate claim payment, and monitor the status of your appeal through adjudication, resulting in increased chances of reimbursement.
We diligently pursue all unpaid or underpaid claims that have exceeded the typical payment or denial window of 25-35 days. During this period, having a reliable medical billing company is critical due to the tendency of insurance companies to complicate the appeal process by imposing shorter filing deadlines.
Medical claims may be denied for several reasons, including:
Inadequate information was provided to process the claim
The lifetime maximum limit with your insurance provider has been met
Human error, such as incorrect coding of the service on your claim
Services received are not covered under your plan
CREDENSE's appeal specialists will identify the reason for denial, handle all necessary paperwork to facilitate claim payment, and work tirelessly to secure your reimbursement. We will directly engage insurance companies to seek a review of any adverse benefit determination, including matters related to patient claims or provider contract issues.
You can rely on CREDENSE to manage all your appeals. While it's reasonable to expect a competent medical billing company to handle the entire revenue cycle, that isn't our only motivation. We believe that you shouldn't have to bear the weight of navigating the inefficiencies of the appeal process; that's our responsibility.
Each appeal is handled on an individual basis. While most of our appeals pertain to medical necessity, every practice has a unique background and often requires a customized approach to the appeal process. As a result, we tailor our appeal strategy to fit the specifics of your case. We save you time by identifying and rectifying any inaccuracies in your insurance documents and liaising with the insurance companies on your behalf to rectify any issues that may arise during the process.
In the event that your request for payment of services is denied by the provider even after an internal appeal, we seek an independent external review. By having a neutral third party examine the information you've submitted, we can typically achieve a favorable outcome in the form of a claim denial overturn for reimbursement.
American Medical Billing Agency | American Medical Response Billing | Denial Analysis in Medical Billing Services | Medicare Credentialing Service | Payment Posting in Medical Billing | RCM