Medical Coding
AAPC-certified coders using ICD-10 and CPT to maximize reimbursement on every claim submitted.
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Core Service
Denial Management
Rapid identification, appeal, and resolution of denied claims — turning rejection into recovered revenue.
HIPAA Compliant
97%+ Clean Claims
Dedicated Account Manager
Every denied claim is potential revenue waiting to be recovered. Our denial management team acts within 24 hours of receipt — analyzing root causes, correcting errors, and filing timely appeals so your practice gets paid for the work it's already done.
The average practice has a denial rate of 5–10%. Left unaddressed, these become permanent revenue losses. Our proactive denial management program doesn't just fix denials — it tracks patterns, identifies root causes, and implements upstream changes that prevent the same issues from recurring.
Key Benefits
24-Hour Response
Every denial is reviewed and actioned within 24 hours of receipt — before appeal windows close and revenue is permanently lost.
Root Cause Analysis
We categorize every denial by type — coding error, eligibility issue, missing documentation — and fix the process upstream.
Higher Recovery Rate
Our appeal success rate significantly exceeds industry averages — recovering revenue that most practices simply write off.
Prevention First
Denial pattern analysis informs upstream billing and coding improvements — reducing your denial rate over time, not just working the backlog.
Payer Intelligence
Deep knowledge of each payer's policies and appeal requirements — so appeals are filed correctly and accepted the first time.
Revenue Recovery
Every successfully appealed denial goes directly back into your collections — turning your denial backlog into measurable revenue.
How We Handle Denials
Our denial management workflow is systematic and relentless. No denial is closed until it's resolved — either through successful appeal, corrected resubmission, or a documented decision that the denial is non-recoverable.
- Daily denial report monitoring across all payers
- 24-hour denial categorization and assignment
- Corrected claim resubmission with supporting documentation
- Formal appeal letters drafted and filed before deadlines
- Secondary and tertiary payer coordination
- Monthly denial trend report with prevention recommendations
Related Services
Denial Management
Proactive denial prevention and rapid appeals that recover revenue most practices don't know they're missing.
Learn MoreCredentialing
Full payer enrollment and re-credentialing to get your providers billing faster without revenue gaps.
Learn MoreStart Recovering Revenue Today
Our free billing audit takes less than 48 hours and shows you exactly where money is slipping through the cracks.
No contracts • No setup fees • HIPAA-compliant at every step
Frequently Asked Questions
Everything you need to know about working with Prime Medical Billing for your denial management needs.
Most practices see measurable improvements within the first 30–60 days. Clean claim rates typically rise within the first billing cycle as we correct root-cause coding and documentation issues. Full revenue optimization — including recovered denials and reduced AR days — is usually evident within 90 days.
No. We integrate with all major EHR and practice management systems including Epic, eClinicalWorks, Athenahealth, Kareo, DrChrono, Practice Fusion, Greenway Health, and more. Our onboarding team handles the technical setup.
Before any data is shared, we execute a formal Business Associate Agreement (BAA) with your practice. All data transfers use encrypted channels, our staff are trained on HIPAA annually, and we conduct regular security risk assessments.
Our average first-pass clean claim rate is 97–98%. We measure this as the percentage of claims accepted by payers on first submission. Each client receives a monthly performance report tracking this and other key metrics.
No denied claim goes unaddressed. Our denial management team reviews every denial within 24 hours, determines the root cause, corrects the claim, and re-submits with supporting documentation before payer appeal deadlines.