Denial Management & Appeals
Don’t let denials eat away your revenue. We identify, correct, and recover denied claims with expert appeal handling.
Introduction
Denied claims directly impact your revenue, disrupt your workflow, and cause unnecessary stress. At Shangrila, we treat every denial as a priority, not an afterthought. Our specialists carefully analyze each rejection, fix the root cause, and resubmit the claim with clean documentation — fast. Got a coding mismatch, missing modifier, eligibility error, or vague denial reason? We go after it with a structured plan. And we don’t just fix what went wrong — we help you prevent it in the future with insights and prevention strategies customized to your practice.
Key Features
- Detailed denial analysis to identify the root cause of each rejection
- Customized appeal letters backed with correct codes and supporting documents
- Quick resubmissions for faster revenue recovery
- Payer communication managed professionally on your behalf
- Recurring denial reporting to improve long-term claim approval rates
Benefits
- Recover lost revenue by reworking and resubmitting denied claims
- Reduce future denials through analysis and process improvement
- Maintain steady cash flow despite payer pushbacks
- Ensure payer compliance with properly documented appeals
- Save time and staff effort by letting experts handle the complex appeal process
How It Works
Collect Denied Claims
We identify and gather denied claims from your system or clearinghouse.
Analyze Rejection Reasons
Each denial is reviewed to pinpoint coding, eligibility, or documentation issues.
Correct Errors & Prepare Appeals
Claims are updated or supported with proper documentation and submitted with strong appeal letters.
Submit to Payers
Resubmissions or appeals are sent according to payer-specific formats and deadlines.
Monitor and Report
We track appeal outcomes and report trends for future improvement.