DENIAL MANAGEMENT
Denial Management Services
Claim denials quietly drain revenue. Many are never worked at all, because staff are busy with new claims. AviRex RCM's denial management service finds why your claims are being denied, appeals the ones worth recovering and fixes the root cause so the same denials stop coming back.
WHAT IS INCLUDED
What is included
Review of denied and underpaid claims by payer, code and denial reason
Root-cause analysis (eligibility, authorization, coding, documentation, timely filing)
Corrected claim submission and structured appeals with supporting documentation
Payer-specific appeal tracking and deadline management
Denial trend reporting for your practice team
Front-end fixes: feedback to registration, coding and providers to prevent repeat denials
HOW IT WORKS
How it works
Review
We pull your denial and remittance data and sort it by reason code and payer.
Prioritize
We rank denials by recoverable value and appeal deadline.
Appeal and correct
We fix and resubmit claims, and file appeals with the right documentation.
Prevent
We share a monthly denial report with recommendations so problems are fixed at the source.
COMMON DENIAL REASONS
Common denial reasons we resolve
- ✓Eligibility and coverage issues
- ✓Missing or invalid prior authorization
- ✓Coding and modifier errors
- ✓Medical necessity denials
- ✓Duplicate claim and timely filing denials
- ✓Bundling and Coordination of Benefits (COB) issues
WHY PRACTICES CHOOSE AVIREX RCM
Why practices choose AviRex RCM
- ✓Root cause, not just rework. We track patterns so denials fall over time.
- ✓Payer-aware appeals. Each payer has its own rules and deadlines, and we work within them.
- ✓Clear reporting. You see what was denied, what was recovered and why.
RELATED SPECIALTIES
We also support practices in:
COMMON QUESTIONS
Denial Management Services — FAQ
A rejection is a claim that fails basic checks before the payer accepts it, usually a formatting or data error, and can be corrected and resubmitted. A denial is when the payer processed the claim and refused to pay it, and it normally needs a correction or appeal.
It depends on the payer and the plan. Appeal windows can range from weeks to a year or more, so tracking deadlines is a key part of denial management. We note the deadline for each denied claim at intake.
Often yes, as long as the payer's timely filing and appeal limits have not passed. We review your older denials and prioritize the ones that are still recoverable.
Industry benchmarks vary by specialty, so we compare your rate with typical ranges for your specialty during the free review.
Find out how much revenue is stuck in denials.
Request a free denial review. No obligation.