Elevate offers a full suite of denial management services, including A/R follow-up, claim status checks, resolution of denied claims, and appeal letters, all with one goal in mind: collecting every dollar due for the services you’ve provided.
The terms denial and rejection are often used interchangeably, but they aren’t the same. A rejected claim was never accepted by the payer, so it never entered their system and has to be corrected and resubmitted. Cash flow often suffers because no one is watching the rejection reports. A denied claim was received and processed and found unpayable, and it represents unpaid services and lost or delayed revenue until it’s corrected or appealed.
This orthopedic practice was losing thousands monthly due to preventable denials and poor documentation. After restructuring their billing workflow and improving coding accuracy, we slashed their denial rate by 60% and restored consistent reimbursements.
A rejected claim was never accepted by the payer because of an error, so it has to be corrected and resubmitted. A denied claim was processed and found unpayable, so it has to be corrected or appealed.
Many can, as long as they’re still within the payer’s correction or appeal window. The oldest and highest-dollar denials should be worked first.