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Denial Management Services

Get Paid What You Deserve. Stop Letting Denials Drain Your Revenue.

Denied claims are not just a nuisance—they’re a direct hit to your bottom line. Studies show 1 in 5 claims is denied or delayed, and up to 65% of denials are never reworked. That’s revenue you’ve already earned but may never see.

At ConnecticutMedBill, our denial management experts combine in-depth payer expertise, advanced analytics, and seamless EHR integrations to resolve denials quickly and prevent them from recurring.

Request a Free Denial Audit

How Claim Denials Affect Your Revenue

Claim denials don’t just slow payments—they can drain your practice’s finances. Every denied claim creates extra work, delays reimbursement, and in many cases, turns into permanent lost revenue. If left unmanaged, denials can quietly erode your bottom line.

  • Here's the real impact denials have on providers:
  • Cash Flow Blockages – Each denial costs an average of $25 to $118 to rework. Meanwhile, the claim sits in AR for 45–90 days, leaving thousands in limbo every month.
  • Permanent Write-Offs – Up to 65% of denied claims are never reworked, leading to annual losses of $50,000–$100,000 for small practices and seven figures for larger groups.
  • Rising Administrative Costs – Reworking denials takes 20–30 minutes per claim, pulling staff away from preventive tasks and driving up overhead.
  • Longer AR Cycles – Industry best practice is <35 AR days, but denial-heavy practices often reach 50–70 days, which risks missing payer deadlines and forfeiting payments.
  • Patient Frustration – Denials often result in surprise bills. A Kaiser survey found that 1 in 6 patients received an unexpected charge due to an insurance denial or coding error.
  • 1 in 5 claims is denied or delayed (Change Healthcare).
  • Denials cost U.S. providers $262 billion annually (AMA).
  • 80–90% of denials are preventable with the right processes (MGMA).
  • Resubmitting within 7 days improves payment success by 50%.
  • Active denial management reduces denial rates to below 5% within 6 to 12 months. Services” page draft we built earlier, so it feels like
  • Our Services

Our Denial Management Services

Eligibility & Benefits Validation

Eligibility & Benefits Validation

We verify patient coverage, deductibles, and benefits before service. This prevents costly denials at the front end.

Coding & Modifier Correction

Coding & Modifier Correction

Our certified coders fix CPT, ICD-10, and modifier errors. Clean claims mean faster approvals and higher reimbursements.

Prior Authorization Denials

Prior Authorization Denials

We resubmit with the missing documentation that the payers demand. This turns authorization denials into approvals and payments.

Medical Necessity Support

Medical Necessity Support

Our team attaches clinical notes, test results, and payer-specific evidence. This ensures treatments meet medical necessity rules.

Duplicate & Bundling Resolution

Duplicate & Bundling Resolution

We analyze payer edits and unbundle when appropriate. Legitimate services are separated and reimbursed without write-offs.

Appeals Management

Appeals Management

From Level I reconsiderations to Level III hearings, we aggressively fight denials. Every claim gets escalated until it's either paid or fully exhausted.

Our Denial Management Process

  • Denial Capture & Categorization: We identify and classify denials by payer, code, and reason—eligibility, coding, prior authorization, or medical necessity.
  • Root Cause Analysis: We investigate why the denial happened, not just how to fix it. This eliminates recurring issues.
  • Appeals & Resubmissions: Our team prepares corrected claims, adds missing documentation, and submits appeals with payer-specific language.
  • Denial Prevention Strategy: We implement coding updates, documentation improvements, and payer rule adjustments to cut future denials.
  • Reporting & Insights: Providers receive clear reports showing top denial reasons, appeal success rates, and payer-specific trends.

Technology & EHR Integrations

Our denial management isn’t manual—it’s powered by automation and smart integrations.

  • Our EHRs and Billing Systems Help You:

  • Auto-flag denials in real time
  • Track payer-specific denial codes
  • Generate prevention insights directly in your EHR
  • Streamline resubmissions without disrupting your workflows
  • We integrate with top EHRs and billing systems, including:

  • Epic
  • Athenahealth
  • Kareo
  • eClinicalWorks
  • NextGen
  • AdvancedMD
  • Availity

Turn Denials Into Dollars with ConnecticutMedBill

Every denial is a chance to recover lost revenue—if managed correctly. ConnecticutMedBill helps providers cut denial rates in half, recover up to 25% more revenue, and significantly shorten AR days.

Schedule Your Free Denial Audit Today

Frequently Asked Questions (FAQs)

Do you handle denials for both Medicare and commercial payers?

Yes. Our denial management team collaborates with Medicare, Medicaid, and all major commercial insurers. Each payer has unique rules, edits, and appeal processes—and we stay updated on all of them to make sure your claims get paid.

We begin working on denials within 48–72 hours of receipt. A quick turnaround reduces the risk of missing payer deadlines and keeps your cash flow steady, rather than waiting weeks for action.

Absolutely. We specialize in denial clean-up projects for claims up to 12–18 months old. Even older claims can sometimes be recovered if they fall within the payer’s timely filing limits, which we review on a case-by-case basis.

Do you prevent denials or fix them?

Both. We resubmit denied claims with corrected coding or documentation, but we also identify patterns that caused the denial in the first place. That means fewer repeat denials and a long-term increase in clean claim rates.

Yes. You’ll receive detailed denial reports that show trends by payer, denial type, and recovery status. These insights help providers understand where revenue is being lost and how it is being recovered.

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