Denial Management& Appeals
Expert denial management and appeals processing designed specifically for behavioral health practices. Turn denied claims into recovered revenue with our systematic approach to denial resolution.
Why Choose Our Denial Management Services?
40% Denial Reduction
Systematic approach reduces future denials
85% Recovery Rate
Industry-leading appeal success rate
7-Day Turnaround
Fast appeal processing and submission
Root Cause Analysis
Prevent future denials with detailed analysis
Comprehensive Denial Management Services
Our denial management services address every aspect of claim denials, from initial analysis to successful appeals, with specialized expertise in behavioral health billing challenges.
Denial Analysis & Root Cause Identification
Comprehensive analysis of denied claims to identify patterns and root causes
- Detailed denial reason analysis
- Pattern identification and trending
- Root cause investigation
- Provider feedback and education
Appeals Preparation & Submission
Expert preparation and submission of appeals with supporting documentation
- Clinical documentation review
- Medical necessity justification
- Peer-to-peer coordination
- Timely appeal submission
Insurance Follow-up & Negotiation
Proactive follow-up and negotiation with insurance companies
- Direct payer communication
- Status tracking and follow-up
- Escalation management
- Resolution negotiation
Performance Tracking & Reporting
Detailed tracking and reporting of denial management performance
- Denial rate monitoring
- Recovery rate tracking
- Trend analysis and reporting
- Performance optimization recommendations
Our Performance vs. Industry Standards
See how our specialized services outperform industry averages
| Performance Metric | Our Target | Industry Average | Improvement |
|---|---|---|---|
| Appeal Success Rate | 85%+ | 65% | +20% |
| Denial Rate Reduction | 40%+ | 10% | +30% |
| Appeal Turnaround | 7 days | 21 days | -67% |
| Revenue Recovery | 92%+ | 75% | +17% |
Ready to Recover Your Lost Revenue?
Stop losing money to denied claims. Partner with our denial management experts to recover revenue and prevent future denials.
"Vertex's denial management team recovered over $180,000 in previously denied claims and reduced our denial rate from 18% to 8%. Their expertise in behavioral health appeals is exceptional."