Denial management that works every denial
A denied claim can still be recovered until the appeal window closes. Our denial management team works every denial, files corrected claims and appeals on time, and fixes the causes so the same denials stop showing up.
- Every denial worked
- Appeals on deadline
- Root-cause fixes
The problems we hear about most
Before practices come to us for denial management, these are the issues that keep coming up.
Denials pile up
When the team is busy, denials wait in a queue until someone has time. Often that's after the appeal deadline.
The same denials repeat
Fixing one claim at a time without looking at the cause means the same denial comes back next month.
Appeals take real work
A strong appeal needs the right documentation and payer-specific wording. That takes time and experience.
Everything included in our Denial Management service
Certified billing and coding professionals handle every part of it, with HIPAA-compliant processes throughout.
Denial categorization
Every denial is sorted by reason code and payer, so patterns are easy to see.
Root-cause analysis
We trace denials back to where they started, whether eligibility, coding, or authorization.
Corrected claims
Fixable denials are corrected and resubmitted quickly.
Written appeals
Appeals are prepared with supporting documentation and filed within payer deadlines.
Payer follow-up
We follow up with payers until each appeal is decided.
Prevention feedback
We share what's causing denials with your team so fewer happen in the first place.
How denial management works with Optima
First, we set up a clear process from day one. That way, your claims keep moving while we get started.
Sort the backlog
We review open denials and rank them by value and appeal deadline.
Fix or appeal
Each denial is corrected and resubmitted, or appealed with documentation.
Track to resolution
Every denial stays on our list until it's paid or properly closed.
Prevent repeats
Monthly trends show the top causes, and we work with you to fix them upstream.
Is denial management right for your practice?
Tap anything that sounds like your practice today.
Let's see if we're a fit
Select the statements that describe your practice to see whether Denial Management would help.
What denial management changes for your practice
Recovered revenue
Denials that would have been written off get worked and appealed.
Fewer repeat denials
Fixing root causes means fewer of the same denials next month.
A clear denial picture
You see denials by reason and payer, and what's being done about each one.
Denial management for 30+ specialties
Our team works by specialty, so they know the codes, modifiers, and payer rules that apply to yours.
Services that work well together
Denial management is the process of reviewing denied claims, correcting or appealing them, and fixing the causes so fewer claims are denied in the future.
Common causes include eligibility and coverage issues, missing prior authorizations, coding and modifier errors, duplicate claims, and missed filing deadlines. Many start at the front end and can be prevented.
Yes. We can take on an existing denial backlog, starting with the claims that have the most value and the closest deadlines.
We look at the denial reason, the documentation, the payer's rules, and the claim's value. If a claim can be fixed and resubmitted, we do that first, since it's usually faster than a formal appeal.
See what denial management could change. Start with a free audit.
First, we'll review a sample of your claims, denials, and A/R. Then we'll show you where your revenue cycle needs attention.