In the complex world of healthcare reimbursement, denied claims are more than just an administrative nuisance—they’re a direct hit to your bottom line. Every denial represents delayed or lost revenue, additional staff time, and potential compliance exposure. According to industry studies, up to 10% of claims may initially be denied, but 90% of those denials are preventable or recoverable with the right processes in place.
Cherry Medical Solutions’ Denial Management Service tackles denials head-on by identifying root causes, correcting claims promptly, and resubmitting them quickly to secure payment. Our proactive approach also prevents future denials, protecting your cash flow and strengthening your revenue cycle.
Denied claims can be caused by many factors:
Left unmanaged, denials increase accounts receivable days, inflate administrative costs, and erode patient satisfaction. An effective denial management strategy recaptures revenue and transforms your billing process into a continuous improvement engine.
We track denials at the payer, provider, and claim level. Using detailed categorization, we identify patterns, such as recurring coding issues or payer-specific trends, to address systemic problems.
Each denied claim is analyzed to determine the underlying reason. We examine EOBs, payer correspondence, and your practice’s internal workflows to find the exact source of the denial.
Once the issue is identified, our experienced team corrects the claim—whether it’s a coding adjustment, added documentation, or resubmission with prior authorization details—and sends it back to the payer promptly.
For denials requiring formal appeals, we compile supporting documentation, draft appeal letters, and pursue the case with the payer until resolution. Our follow-up is persistent and methodical.
We don’t just fix denials—we feed the insights back to your front-end and billing staff to prevent recurrence. This could include updated verification processes, coder education, or new authorization protocols.
We provide clear reports showing denial rates by payer, reason codes, specialty, and dollar impact. These analytics help you negotiate better contracts, retrain staff, and streamline workflows.
We turn denied claims into paid claims quickly, reducing lost revenue and write-offs.
By correcting and resubmitting claims promptly, we accelerate cash flow and improve financial predictability.
Our preventive measures address root causes so denials steadily decrease, creating a healthier revenue cycle.
Denial management is labor-intensive. Outsourcing to Cherry Medical Solutions frees your staff to focus on patient care and other priorities.
We ensure all claim corrections and appeals follow payer rules and HIPAA standards, reducing compliance risks.
Our detailed reporting empowers you to make informed decisions about staffing, training, and payer contract negotiations.
Cherry Medical Solutions combines automation tools with experienced denial specialists:
This hybrid approach allows us to resolve denials quickly while also improving your billing process.
Different specialties face different denial challenges:
Our team is trained across multiple specialties to address these nuances, ensuring maximum recovery and prevention.
The best denial is the one that never occurs. We proactively prevent denials by:
This proactive stance decreases denial rates over time, saving your practice both time and money.
For denials requiring appeals, our process includes:
Our structured appeal management increases the likelihood of overturning denials and recovering revenue.
Denied claims can lead to patient confusion or unexpected bills. We help your staff explain denials and balances to patients clearly, maintaining trust and minimizing complaints. By resolving denials quickly, we also reduce the chance of bills being sent to collections unnecessarily.
Our denial management operations are fully HIPAA-compliant. We use secure data transmission, encrypted storage, and strict access controls. Regular audits ensure our processes meet industry standards and protect your reputation.
A mid-sized orthopedic group was losing over $100,000 annually to unresolved denials. After implementing Cherry Medical Solutions’ Denial Management Service, we categorized denials by reason code, retrained front-office staff on pre-authorizations, and established a 48-hour resubmission protocol. Within six months:
This transformation improved cash flow and freed internal staff from repetitive follow-up.
Our reports go beyond simple denial counts. We track:
These insights support better forecasting, staff training, and payer negotiations.
Our denial management service transforms a reactive process into a proactive revenue protector:
By eliminating denial bottlenecks, your practice enjoys smoother cash flow and more predictable revenue.
Denial management is not a one-time project but an ongoing partnership. We meet regularly with clients to review KPIs, discuss payer changes, and recommend process improvements. This continuous improvement approach keeps your denial rate trending downward year after year.
Denied claims don’t have to be inevitable losses. With Cherry Medical Solutions’ Denial Management Service, you gain a dedicated team that identifies, corrects, and resubmits denied claims quickly—while also addressing the root causes to prevent future denials.
We combine technology, expertise, and proactive communication to recover lost revenue, shorten your accounts receivable cycle, and improve patient satisfaction. By outsourcing this critical function to us, you free your staff from time-consuming follow-up and gain actionable insights into your revenue cycle performance.
In today’s competitive healthcare environment, an effective denial management strategy isn’t optional—it’s essential. Cherry Medical Solutions turns denial management into a strategic advantage, helping your practice achieve financial stability, operational efficiency, and long-term growth.