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CARE CLAIM SOLUTIONS

Denial Management

Turning denials into dollars, one claim at a time.

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Denials Don't End the Story—We Rewrite It

In today’s healthcare landscape, claim denials aren't just occasional—they're inevitable. But at Care Claim Solutions, we believe every denial is an opportunity: to recover revenue, refine workflows, and build a stronger billing foundation.

We help providers:

1

Recover lost revenue by aggressively working every denied claim

Our denial specialists correct errors, resubmit promptly, and fight for every dollar owed.

2

Prevent future denials by fixing the root cause, not just the claim

We analyse trends, identify payer-specific patterns, and adjust workflows to stop recurring problems.

3

Maintain cash flow stability by reducing the denial impact window

By managing denials quickly, we prevent claims from aging out and affecting monthly revenue targets.

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Denials Are Not the End—They Are Our Starting Point

Every denial tells a story—of a missing modifier, a documentation gap, or a payer requirement shift. We read these signals early, address the issues systematically, and close the feedback loop with your front-end billing. Whether you're struggling with aging receivables or inconsistent monthly revenue, our team acts as your financial command centre—driving collections while freeing up your staff for patient-facing care. By syncing directly with your imaging workflow (PACS, RIS, EHR), we help reduce billing friction and increase financial performance. Our approach is proactive, transparent, and designed to shorten A/R cycles, improve first-pass rates, and keep revenue moving steadily month over month.

We Don’t Just Manage Denials—We Solve Them at the Source

Denied claims don't just delay payments—they reveal cracks in billing workflows, payer communications, or documentation standards. At Care Claim Solutions, we don’t view denials as isolated incidents. We treat them as critical signals to fine-tune your revenue cycle for lasting success. Our denial management program is built around early detection, fast resolution, and root-cause prevention. We recover lost revenue, strengthen first-pass claim rates, and provide ongoing feedback to make your billing system smarter with every cycle. Whether it’s a missing modifier, medical necessity rejection, or administrative error—we fix it, fight it, and prevent it from happening again. At Care Claim Solutions, we handle the entire revenue journey—patient intake, eligibility verification, coding, submission, denial resolution, and final collections. Our approach is structured, software-aligned, and custom-built for your practice size and specialty mix. Whether you're a solo provider or managing multi-specialty locations, we make sure every encounter results in accurate billing, faster payments, and clean financial records. Whether you're a standalone imaging centre or part of a larger multi-specialty network, we help you maintain financial accuracy while reducing operational burdens. Our focus is simple: get your claims approved faster, paid quicker, and handled with the accuracy radiology demands.

We don’t just resubmit—we investigate. Our team identifies underlying reasons behind denials and recommends permanent fixes across coding, authorisations, and documentation.

  • Denial pattern recognition
  • Payer-specific rule analysis
  • Corrective workflow adjustments

We act fast. Denied claims are worked within 24–48 hours, with resubmissions and appeals carefully documented to support revenue recovery.

  • 24–48 hour denial action window
  • Full appeal preparation and filing
  • Structured follow-up scheduling

Our denial insights aren’t just backward-looking—they inform smarter first-time claim submissions through scrubbing enhancements and pre-bill audits.

  • Pre-emptive scrubbing improvements
  • Eligibility and authorisation checks
  • Training feedback for billing staff

For complex denials—such as medical necessity disputes or bundled service rejections—we engage directly with payers to secure resolution, using documented evidence and escalation protocols.

  • Direct payer communications
  • Medical record submissions
  • Tiered escalation paths for complex cases

You stay informed through transparent denial dashboards that track volume, trends, recovery rates, and systemic improvements month over month.

  • Denial rate tracking
  • Recovery rate reporting
  • Operational improvement reports