For Billing Teams
Your Expertise: Billing and Coding. Our Expertise: Appeals.
We take the health insurance appeals process off your plate so you can dedicate your time to billing, coding, and revenue cycle management.
The Billing Team Reality
Denials pile up, and the hardest ones aren't billing problems.
You know the codes. You submit clean claims. You follow up on aging accounts. And still, denials pile up.
"Not medically necessary." "Experimental." "Missing documentation" (that you already sent). Some denials are straightforward administrative issues you can resolve quickly. Where others require specialized knowledge of state and federal regulations, specific medical necessity language, and insurance policy interpretation, expertise that's separate from billing and coding.
These complex appeals mean:
- Uncomfortable financial conflicts with patients
- Patients not receiving the care they need
- Increased accounts receivable
- Higher write-off rates
- More time away from your primary focus, clean claim submission and management
- Frustrated providers asking why payments aren't coming through
There's a better solution.
when complex denials sit untouched
Appeals get deprioritized when they require specialized policy and regulatory work.
for core billing workflows
Complex appeals pull teams away from clean claims, posting, and proactive A/R management.
Why Billing Teams Work With Us
Specialized appeals support, without disrupting your workflow
Drive Excellence Within Your Core Domain
Complex appeals require understanding of state and federal regulations, building medical necessity cases, and interpreting insurance policy language. These are distinct from billing and coding workflows, and they pull you and your team away from the activities that drive measurable results: billing accuracy, timely filing, payment posting, and proactive accounts receivable management.
We take the entire appeals process off your workflow. No more researching appeal requirements. No more time on hold. No more drafting detailed letters. No more tracking multiple timelines across different insurance companies. You identify denials that need appeals, we take it from there.
Reduce Administrative Burden
Appeals are time-consuming and unpredictable. One denial might take 30 minutes. Another might require hours on the phone and computer with insurance companies, researching regulations, and gathering documentation. That variability makes it hard to plan your day and hard to justify the time investment when you're measured on collections and clean claim rates.
By working with appeals specialists, you reclaim that time and redirect it toward billing accuracy, timely filing, payment posting, and proactive accounts receivable management. All information is handled through HIPAA-compliant processes to protect patient privacy.
Improve Recovery Rates Without Adding Work
When appeals are confusing or time-consuming, they often get pushed to the bottom of the priority list. That means denials sit unaddressed, write-offs increase, and providers lose revenue.
We make it simple: you flag the denials that should be appealed, we take over the process. Higher recovery rates without expanding your team's workload.
How We Support Your Workflow
You manage everything from patient registration through payment posting. Appeals are just one more responsibility competing for your attention. We integrate into your existing workflow, no disruption to your processes, no steep learning curve. Just specialized support when complex denials arise.
You're managing multiple provider clients, each with different specialties, insurance mixes, and denial patterns. Appeals expertise needs to scale across all of them. We provide consistent, high-quality appeal support regardless of provider type or insurance plan involved. Your clients get better outcomes, and you deliver more comprehensive service without needing to hire additional specialized staff.
Where We Can Help
Denied Claims
When insurance companies refuse to pay for covered care, particularly medical necessity disputes, experimental/investigational denials, and vague "other reasons" that require strategic appeals.
Underpaid Out-of-Network Claims
When reimbursement falls far below usual and customary rates, requiring documentation and negotiation beyond standard billing processes.
Confusing Denials
When you're not sure what the next step is, what documentation is needed, when you can appeal or whether an appeal is even worth pursuing.
Common Denial Types We Handle
Note: We focus on medical necessity and coverage disputes, not administrative, billing, or coding errors that your team handles internally.
Not medically necessary
Experimental
Investigational
Bundling decisions
Missing documentation (when already submitted)
Prior authorization issues
Misquoted verifications
Improper payment deductions
"Other reasons" (the catch-all for unclear denials)
What Makes This Work
You don't need to become appeals experts or train staff on state or federal regulations and appeal timelines. You identify denials that need to be appealed, we provide the specialized expertise to address them.
Our approach comes from years of fighting denials in a real healthcare practice. We understand medical context, clinical documentation, and how to construct appeals that insurance companies actually overturn. That expertise translates into better outcomes for your providers and patients.
An 85% reversal rate isn't luck, it's the result of understanding how insurance companies make decisions and what it takes to change their minds. When you work with us, you're leveraging proven methods that consistently recover revenue.
We use proven state and federal frameworks and modern tools to streamline the process. We also apply clinical understanding and strategic thinking, because appeals aren't just paperwork. They're cases that require expertise to win.
The Bottom Line
Your value to your providers lies in billing accuracy, timely submissions, strong collections, and cash flow management. Complex appeals require specialized knowledge that's separate from your core expertise.
We take the appeals complexity off your plate so you can focus on your expertise: billing, coding, and revenue cycle management.
Ready to Take Appeals Off Your Plate?
Have questions? Contact Us →
Want to understand our approach? How We Help →
Disclaimer
Appeal It Now provides administrative support and appeal preparation services only. We are not a law firm and do not provide legal advice. Please consult an attorney for legal matters.