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Denial management

Stop losing revenue
to rejected claims.

The national claim denial rate hit 12.4% in 2025 — a ten-year high. Each denied claim costs $28–32 to rework. ImmediCare's denial specialists catch errors before submission and fight back on everything payers reject.

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No upfront cost. Pay only when you collect.
Denial management
12.4%
National claim denial rate in 2025 — a 10-year high
$28–32
Cost per denied claim rework (AMA)
54%
Denied claims overturned on appeal when properly worked (AHA)
5–12%
Annual revenue lost to claims that age out unchallenged
Why denials are your biggest revenue leak

Why denials are your biggest revenue leak

Every denied claim represents revenue your practice already earned but hasn't collected. The majority of denials — up to 86% according to MGMA research — are preventable with proper pre-submission scrubbing and coding accuracy. Of the denials that do get through, 54% can be successfully overturned on appeal (AHA). But only if someone actually files the appeal before the timely-filing window closes. Most in-house billing teams don't have time. ImmediCare does.

Pre-submission scrubbing

Claims reviewed against payer-specific edits before submission. Errors caught before they become denials.

Root cause analysis

Every denial categorised by reason code and payer. Patterns identified and fixed at the source.

Denial appeals

Every appealable denial worked immediately — with the correct supporting documentation and clinical notes.

Payer follow-up

Direct follow-up with payers by phone and portal. Nothing sits unworked past 30 days.

Timely filing management

All claims tracked against payer-specific filing deadlines. No revenue lost to late submissions.

Denial rate reporting

Monthly reporting on denial rates by payer, reason code, and provider so you can see exactly what's improving.

Common questions

Denial management FAQs

What are the most common reasons for claim denial?
The most common reasons are incorrect patient information, eligibility issues, coding errors (ICD-10/CPT mismatches), missing prior authorisation, and timely filing violations. ImmediCare addresses all of these systematically.
How long does an appeal take?
Timeline varies by payer — commercial payers typically respond within 30–45 days; Medicare appeals can take 60–90 days at the first level. We track every appeal and escalate when payers exceed their response windows.
What if a claim is ultimately uncollectible?
We'll tell you honestly — and early. Some claims age past the point of recovery. Our job is to catch them before that happens and maximise what's still recoverable.

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