What Is Prior Authorization? - Detailed Guide for Providers
- Prior Authorization
- OneMed Billing
Lower Denial Rates
Faster Recoveries
Root-Cause Resolution
Denied claims are not just delays — they’re lost income unless managed correctly. Many practices either ignore them or lack the time to dig deep.
We take over your denied claims queue, fix the errors, fight rejections, and prevent recurring issues. Our team handles the appeals, resubmissions, and payer calls while tracking every case until resolution.
We don’t just work denials — we stop them from happening again.
From coding issues to documentation lapses and authorization gaps — we identify, correct, and prevent the reasons claims are denied.
Categorizing denial reasons and tagging root causes
Preparing and submitting custom appeal letters
Fixing errors, resubmitting eligible claims, and verifying authorizations
Coordinating with providers for missing documentation or clinical input
Escalating unresolved claims and tracking prevention trends
We plug into your existing billing workflow—no need to switch systems or change routines. Whether you use Athena, Kareo, AdvancedMD, or any major EHR, we retrieve denial files daily or in batches, handle follow-ups, and report back in real-time with payer notes and documentation logs. We also collaborate seamlessly with your in-house billers or outsourced vendors to close the loop on every claim.
Denial rate
Average time to resolve a denial
Percentage of appeals won
Denials written off
12%
22 days
41%
High
4%
8 days
78%
Minimal
We support practices dealing with complex denial
patterns, whether due to specialty coding, out-of-network billing, or
clinical documentation gaps. Our team handles payer appeals,
coordinates with providers when needed, and uses denial trend
analytics to stop issues from recurring.
We support practices dealing with complex denial patterns, whether due to specialty coding, out-of-network billing, or clinical documentation gaps. Our team handles payer appeals, coordinates with providers when needed, and uses denial trend analytics to stop issues from recurring.
You’ll receive regular updates showing what we’ve worked, what we’ve recovered, and what still needs action.
We handle each denial with precision — from discovery to resolution.
Denied claims received from your system or clearinghouse
Denial reasons categorized and logged
Corrective action determined and implemented
Appeal or correction submitted
Follow-up completed until claim is paid or closed
Recurring issues flagged for provider feedback or training
We combine experience, process discipline, and hands-on payer communication to give your denials the attention they deserve.
Yes. We tag each denial and provide monthly reports showing top denial reasons and how to reduce them.
Yes. We manage denials from Medicare, Medicaid, commercial insurers, and third-party payers across all 50 states.
Absolutely. We’ll review your backlog and recover whatever is still within timely filing limits.
We submit appeals via payer portals, fax, or mail based on payer requirements and provide reference numbers for tracking.
We’ll coordinate with your team for any missing documents, signatures, or clinical notes.