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If patient coverage is inactive or incorrect on the date of service, we verify, correct, and resubmit the claim.
If any authorizations are missing, expired, or obtained incorrectly, we manage the appeal and work with your front-end team to prevent recurrence.
If the payer paid less than the contracted rate, we identify the underpayment, dispute it, and recover the difference.
If the documentation doesn't support the level of care billed, we build the clinical case for appeal and identify documentation patterns that need correction.
Our coding denial management services ensure every resubmission is accurate with correct CPT or ICD-10 codes, modifiers, or diagnosis-procedure pairings
Claims that missed the payer's deadline are appealed with proof of timely submission, where available, and address the workflow gaps that caused the delay.
When multiple submissions are flagged as duplicates, we untangle the claim history, apply correct modifiers, and resubmit with proper documentation.
Missing patient information, incorrect demographics, and formatting errors are corrected for same-day resubmission.
DrCatalyst’s denial management strategy is systematic, data-driven, and integrated with our RCM services. Our denial management experts handle denials aggressively and efficiently through two distinct service tiers:
Our professionals execute the heavy lifting of revenue recovery as an extension of your team.
We handle the labor-intensive tasks of Denial Identification, Correction & Resubmission, and Appeals & Follow-ups.
Your billing supervisor maintains control over high-level decision-making while we manage the relentless cycle of refilling and payer advocacy.
Frees your internal staff from the burden of repetitive payer communication and clerical follow-ups.
A dedicated supervisor oversees the entire process of denial identification, root cause analysis, correction, appeals, and reporting.
We conduct diagnostics to identify gaps in clinical documentation and systemic front-end issues behind every denied claim.
Our team manages the technical interventions needed to correct errors and refile claims, minimizing A/R aging.
We lead the charge in relentless payer engagement and strategic follow-ups for secure resolutions on complex denials.
Receive high-level analytics and performance tracking for optimizing your workflows
Our claims denial management services are systematic, data-driven, and integrated into our RCM services. We handle denials aggressively and promptly, as outlined in our RCM service-level agreements.
Preventing denials before claims are ever submitted.
Recovering revenue from older claims that have been overlooked.
Assigned team that understands your practice’s unique financial goals.
Denials and Rejections are effectively worked within 3 business days
Choosing outsourced denials management services helps recover lost revenue and provides data to prevent denials and rejections.
Faster cash flow with improved first-pass claim acceptance rates.
Reduced administrative burden on your internal team.
Higher recovery rates on denied and underpaid claims.
Better visibility and control with meaningful reports about your revenue cycle.
Scalable services that grow with your practice.
Works in your existing systems.
Full transparency with daily productivity tracking, denial trend reporting, and A/R aging dashboards.
We give your business the edge with unmatched features working seamlessly together, delivering precision and efficiency like no one else.
Written protocols Liability Insurance 3+ Levels of Supervision 5 point IT protection HIPAA BAA included Comprehensive reports & KPIs 3rd party HIPAA compliance certification
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