Denial Management & Appeals Services

Candid Billing provides medical billing denial management services and medical claim appeals services for small and growing practices. We review why a claim was denied or rejected, correct what can be corrected, and file an appeal or a resubmission when that is the right next step.

We have particular experience with mental and behavioral health practices, and we also support a range of other outpatient specialties. Practices in New Jersey and New York are a strong focus, and we serve practices nationwide.

Who this is for

This service is for independently owned, small and growing practices that are spending too much time on denied or rejected claims, or that want help following those claims through. It is a good fit if you want insurance claim denial specialists to review the payer's reason, explain what we find, and keep you informed — without having to stand up your own appeals process.

Many of the practices we work with are in mental and behavioral health. We also work with a range of other outpatient specialties. This is not a hospital-system service.

What medical billing denial management services include

The exact work depends on what is open in your accounts, but medical billing denial management services typically include:

• Review of denied and rejected claims, including the payer's stated reason
• Corrections and resubmission where that will give the claim a clean next look
• Medical claim appeals services, when an appeal is the right next step
• Accounts receivable denial follow-up, so denied claims are not left sitting in AR
• A clear view of denial reasons, so your office can see what is getting in the way

Healthcare denial recovery, as we practice it, is careful follow-up — not a promise that a payer will overturn a denial. Open balances that are not denials may belong with our accounts receivable management work, and both can be combined when that is useful.

How medical claim appeals services work

We work inside the software your practice already uses, including TherapyNotes, SimplePractice, Office Ally and other common practice-management systems. If you use something else, just ask. The steps are straightforward, and we do not set the work to a fixed number of days.

1. You tell us about your practice, payers, and the denial or appeals help you want. Please do not send patient or claim information through the website form or by email.
2. Once you're ready, we set up access to your EHR or billing system, review your payers and open or denied claims, and agree on a start date that works for your office. Nothing changes for your team until the plan is set.
3. We review each denial or rejection, correct what can be corrected, and resubmit or file an appeal where that is the right next step.
4. You stay informed. You receive a clear view of denials and open AR, along with regular updates and a real person to call with questions, Monday through Friday, 9 AM–6 PM EST.

Revenue cycle denial prevention starts with understanding why claims were denied, so the same issues are less likely to repeat. When you want help before the visit as well, verification of benefits can be included. Payer enrollment questions can be handled through our medical credentialing services.

Standalone, or part of full-service billing

You do not have to move all of your billing in order to use denial management and appeals. The work is available on its own, and it can also be included in full-service billing and revenue cycle management.

The first month is free on full-service billing. That offer does not apply to standalone denial management or to a billing audit on its own.

Getting started

If you would like help with denied or rejected claims, tell us a little about your practice on our contact page, or call (657) 355-6936, Monday through Friday, 9 AM–6 PM EST. There is no obligation. Please do not include patient or claim information in the website form or in email.

Stop Losing Revenue to Claim Denials

Let Candid Billing help your practice identify, challenge, and work to recover denied insurance claims. Request Your Free Denial and Billing Audit.

Schedule a Call

Pick a time that works for you. Please don't include patient information when booking.

Free initial review, subject to limitations.

Our free initial billing audit reviews claims from the last two years inside your billing system, including denied and rejected claims, unpaid insurance balances, and common coding or enrollment issues, followed by a short call to walk through the findings. Free initial review, subject to limitations. No obligation.

Questions

What happens when a claim is denied or rejected?

If a claim is rejected or denied, we review the reason, correct what can be corrected, and resubmit or appeal where that is the right next step. The aim is to resolve the claim carefully and keep it from sitting untouched in AR. That accounts receivable denial follow-up can be used on its own, or as part of broader billing support.

Can you work denials without taking over all of our billing?

Yes. Medical billing denial management services and medical claim appeals services can be used as standalone support, or as part of full-service billing and revenue cycle management. You do not have to move the entire cycle in order to get help with denials.

Will you file appeals?

Yes, when an appeal is the right next step. We review the denial reason, correct what can be corrected, and file an appeal or a resubmission as the situation requires. We cannot promise that a payer will overturn a denial.

How will we know why claims are being denied?

Reporting includes a clear view of denials and open AR, and we can walk through the patterns we see so your office knows what is getting in the way. You will have a real person to call with questions, Monday through Friday, 9 AM–6 PM EST.

How is standalone denial work priced? Is the first month free?

The first month is free on full-service billing, not on standalone denial management or a billing audit on its own. Pricing depends on your practice's size, specialty and the services you need. Full-service billing is usually a percentage of what we collect, and standalone services like denial management, credentialing, VOB or AR cleanup are quoted separately. Tell us about your practice and we'll send you a clear quote with no long-term commitment. Our free initial billing audit reviews claims from the last two years inside your billing system, including denied and rejected claims, unpaid insurance balances, and common coding or enrollment issues, followed by a short call to walk through the findings. Free initial review, subject to limitations. No obligation. You can also Request Your Free Denial and Billing Audit.