Appeals: Overturning Claim Denials to Increase Reimbursements

Our denial experts will review the process of denial, check whether your denial can be appealed, process all the essential paperwork required to get the claim paid, and manage the status of your appeal through adjudication.

Increase chances of reimbursement

We belligerently follow up on all unpaid or partially paid claims that have gone outside 25-35 days (the average time for a claim to be paid or denied). Having an expert medical billing company is vital during this period, considering how tough insurance companies make the appeal procedure by shortening filing limits and making the process complicated for end users.

Medical Claims Can Be Denied for A Variety of Reasons, Such as:

·        Insufficient info to process your claim

·        Human fault such as putting the incorrect code for the service on your claim

·        Services received are not covered under your plan.

The Lifetime Maximum Limit with Your Insurance Provider Is Reached

At aJust Solutions, our appeal experts will investigate the cause of denial, process all the paperwork necessary to get the claim paid, and work diligently to get your reimbursement. We will personally request insurance companies for a review of an opposing benefit determination, including the patient’s claim for benefits or provider agreement issue.

Spend More Time Focusing On Patient Care

You can trust aJust Solutions to handle all of your appeals. It should be anticipated that a qualified medical billing company completes the whole cycle, but that’s not the only reason we do it. We believe that you shouldn’t have to take on the load of dealing with the inefficiencies of the appeal process and we take it on our shoulders.

Every appeal is done on a case-by-case basis. The majority of our appeals are for medical issues but every case has a different history and often, different requirements. Therefore, we customize our appeal process so that it fits your case. We save you time by identifying and correcting mistakes in your insurance papers and calling the insurance companies on your behalf to correct any errors that may happen along the way.

If after an internal appeal, the provider still rejects your request for payment of services, we request for an independent, external review. By having an impartial third party review the information you provided, we can usually achieve a successful claim denial overturn for reimbursement.

Benefits of creating awareness and educating clients about the process

By creating awareness and educating our clients we make sure that the whole process is transparent. If essential, our team will train you on documenting medical bills. Our team will use our relations with insurance providers to get your appeal sail through the complicated insurance appeal process.