Small denials never get worked. A claim worth a few hundred dollars is not worth forty five minutes of a specialist's time, so it gets written off.
Send ninety days of denials. I will tell you which were winnable, and what they were worth.
Recoverable
Example only. Your figures come from your own rows.
A standard export from your practice management system. Payer, CARC code, count, billed amount.
Every reason code is classified against payer rules and filing windows. Nothing is estimated.
What is winnable, what is already lost, what needs a clinician, and the dollars behind each.
From a report your system already produces. If you can export it, you can send it.
Column 1
Payer
Column 2
CARC code
Column 3
Count
Column 4
Billed amount
We do not want patient data and we do not need it. No names, no member IDs, no dates of birth, no dates of service. If a file you send contains any, we tell you which column, delete it, and confirm the deletion in writing.
Winnable now
Recoverable denials by payer and reason code, and what they add up to.
Already lost
Past the filing window, or really a contractual write-down. No point chasing it.
Needs a clinician
Winnable on the merits, but somebody has to attest to medical necessity.
Every figure is computed from the rows you send. Nothing is estimated, and where we are unsure about a code we say so rather than guessing.
I am building software that works denials. Before selling it to anyone, I need to know it wins the denials that actually cost a practice money. Your export tells me that. The review tells you what is recoverable.
It costs you five minutes and no commitment. There is no patient data involved, so there is nothing to sign. You get something useful whether or not you ever buy anything.
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Vantar Group LLC
Registered
Wyoming, USA
You deal with
One person
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