Denial Management: A Step-by-Step Guide to Getting Claims Paid Faster

Turn Denials into Dollars with a Proactive Strategy

Claim denials are one of the biggest roadblocks in healthcare revenue. Left unmanaged, they can lead to lost income, delayed payments, and unnecessary rework. A strong denial management process helps you recover revenue quickly and prevent future issues. Here's how to do it right—step by step.

Step 1: Identify the Root Cause

Start by analyzing your denial reports. Group denials by category—coding errors, eligibility issues, missing documentation, authorization problems—to understand where things go wrong most often.

Step 2: Categorize and Prioritize

Not all denials are created equal. Focus on high-dollar claims, recurring issues, or those within timely filing limits first. This ensures your time is spent where it matters most.

Step 3: Correct and Resubmit Quickly

Act fast. Review the denial reason, make necessary corrections (e.g., fix codes, attach documents), and resubmit within the payer's appeal window to avoid revenue loss.

Step 4: Appeal When Necessary

If the denial is incorrect, file an appeal with supporting documents. Be clear, concise, and follow each payer’s appeal format and timeline.

Step 5: Track Resolutions

Maintain a log of all denials, follow-ups, appeal status, and outcomes. Use this data to spot trends and improve your front-end processes—like patient eligibility checks and coding accuracy.

How AccordPro Helps You Get Paid Faster

We handle the full denial management cycle, including:

• Root-cause analysis and trends

• Timely corrections and resubmissions

• Appeal preparation and tracking

• Reporting to reduce future denials

With AccordPro on your side, you recover more revenue and improve long-term claim success rates—without the stress.

Need Help Managing Denials?

📞 Call us at 425-215-0517