DENIALS & APPEAL MANAGEMENT


$6 per hour* onwards


Our Denials and Appeals Management service is designed to increase Revenue Collection for Physician offices.


Our expertise includes managing denials for following reasons:


  • Authorization Issues
  • Referral Issues
  • Medical Necessity and Medical Records requests
  • Non-Participation with Insurance Network
  • Terminated Insurance
  • Coordination of benefits
  • Inclusive Procedures
  • Partial Payments
  • Out-of-network claim status and deductibles
  • EDI Rejections
  • Letter of Protection from Attorney cases
  • No status and No claim on File
  • Workers’ Compensation
  • PIP cases


  • Obtaining an accurate reflection of denials for a multispecialty practice can be challenging. The denial rate for a multispecialty group practice may be 5 percent, but that overall rate may include a 20 percent denial rate for obstetrics and a rate of 1 percent for family practice.
  • You need to look at denial rates by type of specialty. We segregate denial rates for primary care [family practice and internal medicine] from those for specialties that have potentially higher denial rates.
  • When the denial rate is high, it should be looked at immediately. We address two areas of denials: why they are occurring and preventing them in the first place.
 
 

Contact Us


Contact Person : Margarita Pile

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Matrix Health Solution

Our strategy is to build productivity through the use of technology, highly trained personal who deliver results in a timely fashion, and customized consulting services. With resources composed of 52+ employees nationwide and 350+ back office employees overseas.

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