Denial management services for small practices
Denied claims need a next action, an owner and a deadline. Synergy helps your practice work a defined denial backlog or manage ongoing denials as part of your billing team, using your existing system.
Keep your current biller and assign selected denial work, or include denial management in full medical billing. We first review the payer issues, available documentation, deadlines and access needed to agree a practical scope.
Get help with a backlog or ongoing denial follow-up
- Your billing team needs extra capacity. Assign an agreed group of denied claims while your office keeps new submissions and payment posting.
- You inherited unresolved claims. Separate the older backlog by payer, age, denial reason, prior action and current deadline. Aged A/R recovery may be relevant when the problem extends beyond denials.
- Denials are part of a wider billing gap. Discuss full billing support for your small practice, including the handover of submissions, posting and follow-up.
Describe your denial problem in general terms. Tell us the billing system, common reasons, approximate claim ages and whether a deadline is approaching. Do not attach patient records or claim files.
From denial review to a documented next action
| Step | What the review covers | What to record |
|---|---|---|
| Triage | Read the payer decision, reason and remark codes, claim history and applicable filing or appeal deadline. | Issue, available action, deadline and missing information. |
| Correct or appeal | Use the payer's appropriate correction or appeal route for the issue and supporting evidence. | Required documents, responsible person and submission confirmation. |
| Follow through | Track payer references, responses and the next follow-up or practice decision. | Last action, next action, owner and final disposition. |
| Address recurring causes | Group repeated eligibility, authorization, coding or enrollment issues for the practice and billing team. | Process change to review and who is responsible for it. |
The payer determines the claim outcome. Clinical decisions and documentation remain your practice's responsibility. Missing evidence, coverage terms and expired deadlines can limit the actions available; not every denied balance can be recovered.
What we need from your practice before work starts
Agree which providers, payers, service dates and claim types are assigned. Identify who continues new submissions and posting, who supplies clinical documentation, and who can approve adjustments. Complete the required agreement and secure handoff before patient information is shared.
Work uses practice-controlled access in your existing billing system. A login alone is not a completed handover: the team needs denial details, prior actions, deadlines and a named practice contact for unresolved questions.
What the 48-hour denial-work target means
Synergy's target is to begin denial work within 48 hours once the denial information, required access and supporting information are available. This is a workflow target. It does not promise appeal submission, a payer response or payment within 48 hours.
Flag approaching payer deadlines when discussing the assignment. A new service arrangement does not extend a filing or appeal deadline.
Rejections, denials and underpayments need different work
A clearinghouse rejection requires review of the acceptance error. A payer denial requires review of the adjudication decision. A possible underpayment needs comparison with the applicable contract, benefits and adjustments; payment below the billed charge is not automatically an error.
See the denial work-queue checklist, underpayment review and contractual adjustments for the distinctions.
Review the work, not just a backlog balance
Agree reporting that shows assigned claims, denial reasons, deadlines, actions, payer decisions and unresolved practice questions. Keep inherited backlog separate from new denials. A reduction in an A/R balance alone does not establish cash recovered.
See fictional billing-report examples without a sign-up. They illustrate reporting, not a forecast of your results.
Start with a free practice audit
- Describe the problem. Share your specialty, provider count, system, broad denial reasons and approximate claim ages.
- Discuss fit and a secure review. Identify the deadlines, documentation and access needed to assess the work. Do not use the public form for patient records.
- Confirm scope and quote. Review the proposed assignment, responsibilities, reporting and fees before deciding. An initial inquiry does not start a paid service.
Request help with your practice's denied claims or call 630-708-0271.
Agree the service scope and quote before work starts
Standalone denial support has an agreed scope and quote; it does not automatically include all full revenue cycle management services. Provider credentialing is included free with full RCM. The separate 30-day billing trial has eligibility and service terms; do not assume it applies to a standalone denial engagement. Review pricing and included services and confirm the applicable terms before starting.
Frequently asked questions
Can you work denials while we keep billing in-house?
Yes. Selected denial work can be scoped separately from full medical billing. Agree the providers, payers, service dates, claim types, documentation responsibilities, reporting and fees before work starts.
Will you correct the claim or file an appeal?
The payer decision and issue determine the route. Some billing errors require a corrected claim, while an adjudicated denial may require an appeal and supporting evidence. Review the payer's process, deadline and prior actions before choosing the next step.
Does the 48-hour target mean payment within 48 hours?
No. It is Synergy's target to begin denial work once the information, access and supporting material are available. Appeal submission, payer response times and payment depend on the claim and payer process.
Can you review denials older than 90 days?
Yes, but age alone does not establish whether an action is available. Review the payer decision, current deadlines, documentation and prior actions first. Some older claims have no supported recovery route.
How is standalone denial-management support priced?
Standalone denial support has its own agreed scope and quote. Review the account volume, ages, required work, reporting and practice responsibilities before agreeing fees. The separate full-billing trial does not automatically apply to standalone denial work.
What should we include in the first inquiry?
Describe your specialty, billing system, common denial reasons, approximate claim ages and any approaching deadline in general terms. Do not send patient names, claim files or medical records through the public form; arrange an agreed secure review if needed.
Get a plan for your practice's denied claims
Start with the billing system, denial problem and work you need covered. We can discuss fit, scope and a secure next step.
No long-term contracts • Cancel anytime with 30 days' notice • HIPAA compliant