Denials and Appeals Management Services

Denials and appeals management services for providers that want to improve their clean claims rate, better manage denied claims, and access expert assistance in handling appeals.

What’s included in Denials and Appeals Management Services

  • Denials and appeals management services

    • Facilitate the successful appeal of denied claims
    • Access our expertise in analyzing payer adjustment codes from remittance advice
    • Includes case management and utilization review
    • Enable our experienced staff to advocate on your behalf with payers
    • Get help resolving underpayments related to interpretations of contract, policy, or documentation
  • Payer audit services

    • Leverage our expertise in appealing Medicare notifications
    • Rescind payments via the Medicare Recovery Audit Contract Program (RAC)
    • Address other commercial and government payment audits
    • Rely on our team to coordinate medical chart reviews and meet appeals deadlines
    • Alleviate the administrative drain on staff in patient financial services, case management, and health information management
  • Ongoing system edit and workflow maintenance

    • Help keep your team informed of regulatory changes
    • We’ll review and implement payer bulletins to educate your staff
    • Get tutorials to facilitate a proactive approach to denials management
    • Get ongoing edits maintenance, workflow modifications, and system cleansing
    • Help ensure your claims submissions reflect payer compliance updates and regulatory changes
  • Detailed denials management process reporting

    • Gain valuable trending insights and recommendations
    • Address the root causes of denials to prevent them from reoccurring
    • Leverage detailed reports on denials and underpayments during payer contract negotiations

Help managingmedical billing denials

Denials and Appeals Management - businessman working at call center

Denials management in healthcare to help improve clean claims rates

Get help identifying and correcting root causes of denials to improve your clean claims rate. Our healthcare denials management services help streamline workflows for greater efficiency, faster appeals, and improved cash flow. You’ll get specific recommendations for documentation, edit improvements, claims management, and process improvements.

Denials and Appeals Management - two businesswomen working at call center

Our program supports compliance

Our denials management services can improve compliance.” Our custom “Gold Standard” compliance program aligns with the requirements of the Office of Inspector General.

Denials and Appeals Management -  businesswoman in office smiling

Leverage our teams to reduce staff burden

Help reduce your cost of managing denied claims and the administrative burden on staff. Our clinical and technical teams include skilled nurses and revenue cycle experts, and because our services are system-agnostic, these services can be delivered onsite or remotely within your existing systems. Rely on our expertise to resolve underpayments.

Our outcomes

View all insights


Need support for
this solution?

Let’s start a conversation

We’re here to help you find out how our services could benefit your organization. Complete the quick form to the right, and someone will reach out to you soon.

Our experts will:

  • Discuss your individual use case and business needs
  • Explain our features, benefits, and services
  • Show how this solution can help achieve your goals

Want more information about our services? Start here.

Thank You

We appreciate your interest in Change Healthcare. A member of our team will contact you to better understand your needs and discuss potential solutions.

Together, we are accelerating the journey toward improved lives and healthier communities.