What is appeal management?

It is the process of reviewing denied claims, preparing appeal letters, submitting required documents, and following up with the payer to overturn the denial.

When should a denied claim be appealed?

A claim should be appealed when the service was correctly billed and supported by documentation, but the payer still denied it. Most appeals must be submitted within 30 to 60 days of denial.

Can all denied claims be appealed?

No. Some denials are final based on policy or contract terms. But many denials, especially administrative or documentation-related ones, can be successfully appealed.

Who should handle medical claim appeals in a practice?

Ideally, appeals should be managed by experienced billers or specialists who understand payer rules, deadlines, and documentation requirements. Many practices outsource this to reduce delays.

Recover Lost Revenue With Appeal Management Services

Strong Appeal Letters

Faster Reversals

Lower Write-Off Rates

Writing Off Denials Too Soon?

When denials go unchallenged, you're not just losing revenue — you're missing out on money your practice has already earned. Most denied claims are preventable or appealable, but many teams don’t have the time to handle them properly.

Our team takes over your appeals queue. We review each denial, gather documentation, write payer-specific appeal letters, and follow through until the claim is resolved.

We turn denied claims into recovered income.

We Manage the Entire Appeal Lifecycle

From initial denial analysis to final resolution, we cover everything needed to give each claim the best chance of approval.

Step 01

Review

Review of denial codes and claim data

Step 02

Categorization

Categorization of appealable vs. non-appealable denials

Step 03

Creation

Creation of detailed appeal letters with supporting evidence.

Step 04

Submission

Submission via portal, fax, or mail with tracking and resolution follow-up.

Step 05

Peer-to-peer

Peer-to-peer support, provider coordination, and audit logs

See a Demo of Our PA Workflow

You Focus on Billing — We Handle the Appeals

We support most major billing platforms and clearinghouses. Denials are handed off via batch files, email, or portal. We coordinate with your internal coders or billers as needed, and we share real-time appeal status updates while tracking all documents securely.

Real Practices. Real Recovery.

Metric

Appeal win rate

Time to file appeal

Monthly recovered revenue

Denials written of

Before OneMed

39%

5 to 7 days

Low

Frequent

After OneMed

76%

1 to 2 days

Consistent growth

Reduced significantly

Our appeals were inconsistent, and many denials just sat in the system. Since partnering with OneMed, we’ve recovered thousands in claims we thought were lost.”

— RCM Director, Multispecialty Group

Appeals That Go Beyond the Basics

We handle complex appeals that require more than a templated letter. Our team supports cases involving prior authorization, medical necessity, and coding-related denials. We coordinate with providers for peer-to-peer reviews or clinical documentation when needed, and we customize every appeal based on the specific language and expectations of the payer. Whether you're dealing with Medicare, Medicaid, or commercial plans, we have experience across all major specialties — including behavioral health, infusion, DME, and surgical services.

Know What Was Appealed, When, and Why

We provide full visibility into every appeal submitted, including details, follow-ups, and outcomes — so you never have to guess

Daily appeal logs with denial codes and payer references

Reversal and resolution status updates

Reports on win rates and appeal reasons

Alerts on time-sensitive or high-dollar appeals

Documentation archives for future audits or compliance

Talk to a Specialist Today

Our Step-by-Step Appeal Process

We move each denied claim through a clear path from problem to payment.

Step

01

Denial is received and reviewed

Step

02

Root cause and appeal eligibility determined

Step

03

Appeal letter created and documentation gathered

Step

04

Submission completed with tracking

Step

05

Follow-up with payer begins

Step

06

Final status updated in logs and reported to your team

Request a Demo of Our Claim Scrubbing Workflow

Referral Management That Doesn’t Let Anything Slip

Feature

Manual appeal writing

Payer-specific documentation

Peer-to-peer scheduling support

Fast turnaround (1–2 days)

Denial root-cause tracking

In-House Staff

Limited

Rare

Sometimes

Basic

Software Tools

None

OneMed Billing

Yes

Full reports

We don’t just log referrals — we manage them from start to finish.

Talk to Our Denial Team Today

Frequently Asked Questions

Do you track outcomes?

Yes. Every appeal is tracked through to resolution, and results are logged and reported.

Do you write and submit appeal letters?

Yes. We create custom letters and submit them based on the payer’s preferred method (portal, fax, or mail).

Can you handle medical necessity or clinical appeals?

Absolutely. We coordinate with providers for documentation and can support peer-to-peer processes.

What payers do you support?

We manage appeals for Medicare, Medicaid, and commercial payers across all 50 states.

How quickly can you file appeals?

Most appeals are submitted within 24 to 48 hours after denial review.

Read our Latest Blogs

Aug 27, 2025

What Is Prior Authorization? - Detailed Guide for Providers

Prior Authorization
OneMed Billing

Aug 26, 2025

Top 10 Clearinghouses in Medical Billing in 2025

Medical Billing
OneMed Billing

Aug 23, 2025

Everything About Independent Physician Association (IPA)

Medical Billing
OneMed Billing

Explore More Blogs

HomeOur Services Appeal Management Services

Fight Denials. Recover Revenue. Get Paid What You Deserve.

Writing Off Denials Too Soon?

We Manage the Entire Appeal Lifecycle

Review

Categorization

Creation

Submission

Peer-to-peer

You Focus on Billing — We Handle the Appeals

Real Practices. Real Recovery.

Metric

Before OneMed

After OneMed

Appeals That Go Beyond the Basics

Know What Was Appealed, When, and Why

Daily appeal logs with denial codes and payer references

Reversal and resolution status updates

Reports on win rates and appeal reasons

Alerts on time-sensitive or high-dollar appeals

Documentation archives for future audits or compliance

Our Step-by-Step Appeal Process

01

Denial is received and reviewed

02

Root cause and appeal eligibility determined

03

Appeal letter created and documentation gathered

04

Submission completed with tracking

05

Follow-up with payer begins

06

Final status updated in logs and reported to your team

Referral Management That Doesn’t Let Anything Slip

Frequently Asked Questions

Do you track outcomes?

Do you write and submit appeal letters?

Can you handle medical necessity or clinical appeals?

What payers do you support?

How quickly can you file appeals?

Read our Latest Blogs

What Is Prior Authorization? - Detailed Guide for Providers

Top 10 Clearinghouses in Medical Billing in 2025

Everything About Independent Physician Association (IPA)

Home Our Services Appeal Management Services