Medical Billing Services
Day-to-day claim operations that feed cleaner submissions.
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Remote RCM support for US practices
Denial Management & Accounts Receivable Recovery
Denial management finds why claims failed, prioritizes recoverable balances, and reports recurring causes for US practice owners and administrators. MB Claims works corrected claims, appeals, and aging queues so prevention owners—not only phone follow-up—can reduce repeat remittance failures farther upstream.
Scope of support
Built around the needs of your practice
- Denial categorization and root-cause analysis
- Timely filing and appeal deadline review
- Corrected claim and appeal preparation
- Payer portal and phone follow-up
- Aging segmentation by payer, balance, and status
- Recurring denial trend reporting
A practical, accountable workflow
Scope, system access, responsibilities, reporting and escalation paths are documented during onboarding. Services are tailored to specialty, payer mix, practice size and the condition of existing accounts receivable.
How denial management work runs
1. Build an actionable denial inventory
Before dialing, we refine inventory with remittance reasons, claim history, dates of service, balances, last actions, and remaining appeal or filing windows. Zero-balance noise and non-actionable contractual adjustments are separated from true work. That inventory becomes the control document for weekly huddles. Specialty concentration—such as behavioral health session limits—is easier to see once categories are clean. Connect findings to medical billing and credentialing when causes sit upstream.
2. Prioritize by deadline risk and recoverable value
A smaller balance near a hard deadline can outrank a larger balance with more time left. We weigh payer, denial reason, documentation availability, and remaining rights. Deadline discipline is one of the few controls practices fully own once a denial has posted. For filing-limit context by payer type, see timely filing by payer type.
3. Choose corrected claim, appeal, or documentation request
Repeatedly sending the same claim does not fix eligibility, authorization, coding, or enrollment problems. We review history before choosing a path. If the chart cannot defend medical necessity, an appeal may not be the honest next step. Coding patterns may need medical coding support; front-end eligibility themes may need front-desk training.
4. Work the queue and document next actions
Portal work, payer calls, and written appeals are logged with follow-up dates so handoffs stay coherent. We do not invent extended deadlines or promise recovery after rights expire. Engagements can stand alone on aging recovery or connect to broader RCM scope.
5. Turn categories into prevention owners
Recovering one claim is useful; preventing the next twenty is better. Recurring categories route to eligibility, authorization, documentation, coding, enrollment, or payer configuration owners. Our denial management guide expands the playbook for leaders who want an internal checklist before outsourcing.
Prevention is part of denial work, not an optional add-on
Working appeals without naming prevention owners guarantees the same remittance reasons return. Eligibility, authorization, coding, enrollment, and documentation each need a clear internal owner when categories cluster. Specialty patterns—therapy units, imaging auth, DME proof-of-delivery—should be called out so teams stop treating every denial as a generic phone task. Recovery still cannot be guaranteed; documentation, contracts, and remaining rights control outcomes.
Practice inputs
What the practice provides
The practice provides remittance access, claim history visibility, appeal rights contacts, clinical documentation for supportable appeals, and owners for upstream fixes. Summary aging and denial exports speed the free medical billing audit. Without documentation, some appeals cannot proceed honestly.
Process stages
Timeline: onboarding to steady-state
Onboarding confirms access, denial categories to prioritize, and reporting cadence. First work builds or cleans the inventory and starts the priority queue. Steady-state combines queue work with weekly category reporting to prevention owners. No invented overturn SLAs—only the free audit’s 5-business-day written review timing is stated as a fixed commitment for summary-report reviews.
Reporting
What gets reported
Reporting covers denial categories, payer concentration, aging segments, deadline risk items, appeal versus corrected-claim mix, and prevention owner assignments. We describe KPI definitions without publishing sample overturn results.
Pricing: 2.99%–6% of collections, or a $1,000 per month minimum, whichever is higher. Your rate is set after a free medical billing audit. See pricing.
Security & privacy
BAA with every client and work inside your EHR
MB Claims signs a Business Associate Agreement with every client before protected health information is handled. Day-to-day claim and enrollment work runs inside the practice EHR and practice-management tools you already use—see supported systems on our EHR partners page. We do not market a privacy-rule certification badge; we operate under BAA obligations, access controls you approve, and documented escalation paths. Role-based access, audit-friendly notes, and least-privilege credentials are confirmed during onboarding so administrators know who can view what.
Common questions
Frequently asked questions
Can you work old accounts receivable?
We can review aging inventory and identify balances that remain actionable based on filing limits, appeal rights, documentation, and payer status. Recovery cannot be guaranteed.
Do you appeal every denied claim?
No. Each claim is reviewed for cause, supportability, deadlines, and payer requirements. Some claims need correction, additional documentation, or contractual resolution rather than an appeal.
Will you report why denials are happening?
Yes. Root-cause and trend reporting is a core part of the workflow because prevention is more valuable than repeatedly correcting the same issue.
What denial categories do you track?
Typical categories include eligibility and demographics, authorization, coding and documentation, enrollment and roster, medical necessity, timely filing, duplicates, and payer processing errors—adjusted to your remittance data.
How do you prioritize the work queue?
We weigh balance, age, denial reason, payer, documentation availability, and remaining filing or appeal windows. Deadline risk can outrank a larger balance with more time left.
Can denial management stand alone without full billing?
Yes. Engagements can focus on denial and aging recovery while your team keeps day-to-day billing, or they can connect to broader medical billing and RCM scope.
Do you guarantee an overturn percentage?
No. Overturn and recovery results depend on documentation, payer policy, contractual terms, and remaining appeal rights. We report categories and outcomes honestly.
Free medical billing audit
Find the revenue cycle gaps holding back your practice
Send summary reports (A/R aging by payer, denial summary, monthly collections). Within 5 business days, you'll get a written review of where your revenue is stuck, what to fix first, and your rate. No patient data is needed.
Related services and resources
Medical Credentialing
Fix enrollment and roster gaps that create denial categories.
Explore service →Front-Desk Training
Reduce preventable front-end denials at verification and check-in.
Explore service →Blog
A Practical Guide to Medical Billing Denials
Categorize denials, prioritize balances, and assign prevention owners.
Read guide →Blog
Timely Filing Limits by Payer Type
Protect recoverable balances with filing-window awareness.
Read guide →