Denial Management Service

Denial Management Processing:

Whatever be the reason, most claims denials are a direct result of staff oversight. We at BillingParadise are equipped with the best medical coding and billing professionals, hand-picked for their expertise in the domain. These professionals are perpetually enrolled in continual staff education initiatives, so as to possess the most up-to-date knowledge on the billing and coding guidelines.

Insurance companies in general have an approved list of procedures or diagnosis combinations that they would pay for. BillingParadise maintains a database of such approved combinations by different insurance companies and is up-to-date on the same. Our highly endorsed coders ensure that the highly paid and highest approved combination of procedure and diagnosis codes are used to ensure maximum payment and instant approval.

Quick justification:

  • Effective tracking methodologies
  • Identifying the root-cause for denials
  • Applying technology that is up-to-date
  • Pre-service, concurrent, and post-service reviews.

Hire the best Denial Resources now

Our Denial Management Service Workflow

Denial Manager gives complete and immediate visibility into each claim and denial

 Denial Management Service

Apart from our successful denial management service workflow, we provide our denial management templates
that can categorize, sort, and identify the different types of denials according to priority saving you time and energy.

BillingParadise’s Denial Management Services Results

Denial management services by Billing Paradise for efficient healthcare revenue cycle


Decrease in the denial rate.


Productivity improvement.


Reduced operational costs.


Reduction in aged A/R.


Reduction in DNFB accounts.


Achieve net collections.

Major Specialties Denial Management Services by BillingParadise

The key elements we focus on during Denial Management

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Identify chances to rectify or correct the problems that cause claims to be denied by insurance companies.

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Categorize denials by reason, cause, source, and other underlying factors.

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Monitor the root causes and construct effective denial management service strategies.

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Implement preventive measures and other post-denial techniques to effectively appeal and resolve unfounded denials.

Our Denial Management Service Highlights

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All denials are routed to the denial analysis department. Denials are segregated into line item and full denials

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DenialAnalyzer, our denial management and reporting app, gives you realtime insights

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All claims are categorized into different follow-up groupings.


We work with all federal and commercial payers and have strong knowledge of their payment mechanisms

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Redundant processes are automated. This cuts back on cycle times. Recover money faster.

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Software that identifies, isolates, quantifies and categorizes denials to help you lower your denial rate and spot revenue leakage sources.

Know more about Our Denial Software

The Denial Management tool algorithm analyzes the denied claim under the following protocols

Illustration of a denial management tool utilizing advanced algorithms for efficient revenue cycle management

Appeal Automation

Appeal forms for most of the payers are listed. If the required appeal form it is uploadable?
Denied claim information is automatically populated in the appeal form.

Audit Control

The audit control system tracks the entire claim history from the first submission to the end of denial or payment. So no need for jumping from PMS, and EHR to the denial tool.

Skilled Denial Management Staff

Image of expert eligibility staff verifying patient eligibility for accurate healthcare revenue management

BillingParadise’s seasoned denial management specialists with over 5 years of experience across various specialties, insurances, and states, giving them a superior advantage in understanding insurance guidelines and preventing denials.

Our Denial Management Tool

Screenshot of an all-in-one eligibility platform streamlining patient eligibility verification for efficient revenue cycle

Our denial management tool has an inventory for more efficient response, with analytics creating 13 default pre-set denial maps. The tool is customizable for unmapped denials & It can auto-populate errors & denials & provides resolution for denied claims.

RPA Denial Management Technology

Illustration showcasing robotic process automation (RPA) technology for fast and accurate patient eligibility verification

BillingParadise’s RPA denial management technology has proven increased productivity, quality, and efficiency compared to denial management staff (FTE) allowing your healthcare organization to continue denial management operations 24/7 365 days a year.

In case of rejected claims we extensively aid in identifying the issues that led to the rejection and those need to be fixed. We also take up the added responsibility of identifying the core of the rejections thereby trying to avoid the recurrence of errors leading to denials.

BillingParadise also maintains an internal database of rejected and underpaid claims of various insurance carriers to serve as an expeditious source of reference for similar cases in the future. This drastically cuts down the denial management time-frame and puts the money where the mouth is-in the physician's pockets.

Follow Up:

And in most cases, the in-house staff doesn't aggressively follow up on the denial with the payer and invariably the claims come to be written off. All this can be avoided only with a dedicated and enthusiastic denial management team that expertly teams up with certified coders and other billing professionals to resolve the situation at the earliest and to its best. At BillingParadise, we deploy a comprehensive tracking system for regular follow-up of deferred and rejected claims. We exploit a regular follow-up strategy by tracking the claims submission and settlement phases ensuring that your collections are on track.

There may be varied reasons for a claim's rejection, it may be a modifier that is out of place or a combination of codes not allowed under the CCI edits, or it just could be that appropriate pre-authorization for the particular procedure, as mandated by the patient's carrier was not obtained at the first instance of the patient coming in. Reasons may be multiples of any number whereas the solution is one – BillingParadise.

Just make a call @ 1-(888)-571-9069 to know more about our services.

Illustration highlighting rapid adjudication process (RAP) for effective denial management in revenue cycle

Denial software

Review repeated denials at a glance

It eliminates the need to run multiple reports. View Denial summaries at a glance

Specialty Focused Billing Services

We have specialized teams of AAPC certified medical billing specialist who hold speciality specific certifications to handle your billing and claims management