Denial Management

Stop denials at the source, not after the fact

Most denial management is reactive. Ours starts before the claim goes out, using derm-specific rules and data from 200+ practices.

0%+

First-pass clean claim rate

0 days

Average A/R vs ~45 industry

0+

Dermatology practices

$0.00B

Annual charges managed

Scrub claims before they go out

We check every claim against derm-specific rules for coding errors, modifier mismatches, and payer quirks before it's submitted. That's how we hit a 98%+ first-pass clean claim rate while the industry sits near 85%, so fewer claims come back and your team reworks less.

Denial insights flowing into a modular rules engine
Denial alerts clustered by root cause across derm-specific patterns

Spot payer trends across 200+ practices

When a payer starts flagging a modifier or diagnosis code, we catch it across our whole client base and update scrub rules before your claims get hit. You get the intelligence of $1.13B in annual charges and 1,246+ providers, a dataset no small biller can match.

Fix what causes the denial, not the claim

A new denial isn't a resubmit-and-move-on event for us. We trace it to its source, whether coding, eligibility, authorization, or a payer change, then update the rules so it doesn't recur. Our coders handle Mohs staging, path reads, and modifier stacking the way you bill.

TPE, RAC, and appeals documentation protected under audit defense
Denial insights flowing into a modular rules engine

Defend you through any audit

TPE, RAC, UPIC, and ADR audits are rising in dermatology. We manage the full response across hundreds of practices, from documentation review to appeals to outcome tracking, and we structure your coding to hold up before the request ever arrives.

How we keep denialsfrom happening

Scrub claims before they go out

We check every claim against derm-specific rules for coding errors, modifier mismatches, and payer quirks before it's submitted. That's how we hit a 98%+ first-pass clean claim rate while the industry sits near 85%, so fewer claims come back and your team reworks less.

Fix what causes the denial, not the claim

A new denial isn't a resubmit-and-move-on event for us. We trace it to its source, whether coding, eligibility, authorization, or a payer change, then update the rules so it doesn't recur. Our coders handle Mohs staging, path reads, and modifier stacking the way you bill.

Spot payer trends across 200+ practices

When a payer starts flagging a modifier or diagnosis code, we catch it across our whole client base and update scrub rules before your claims get hit. You get the intelligence of $1.13B in annual charges and 1,246+ providers, a dataset no small biller can match.

Defend you through any audit

TPE, RAC, UPIC, and ADR audits are rising in dermatology. We manage the full response across hundreds of practices, from documentation review to appeals to outcome tracking, and we structure your coding to hold up before the request ever arrives.

Built to hold up under scrutiny

HIPAA compliant

Every workflow, data handoff, and communication in our denial management process meets HIPAA standards. Your patient data is handled with the same care we'd want for our own.

Certified derm coders

Our coders are certified and trained in current CPT, ICD-10, and payer-specific dermatology guidelines, from biopsies and destructions to Mohs and pathology interpretation.

Audit ready by design

We don't just respond to TPE, RAC, UPIC, and ADR audits. We structure coding and documentation to withstand them from the start, so a records request is routine, not a fire drill.

Full transparency

You see every denial, root cause, and appeal outcome. We also track payer policy and CMS changes that affect derm billing, so you stay current without doing the watching.

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We'll review your last 90 days of billing data and show you exactly whereyou're leaving revenue behind. Takes 30 minutes. No strings attached.

Most in-house teams and smaller vendors react to denials after they happen, then resubmit and move on. Without trend data from 200+ dermatology practices, they can't see the patterns that cause denials in the first place. Our approach is prevention-first: we fix the root cause so the denial doesn't recur. That's the difference between a clean claim rate near 85% and one above 98%.

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