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Denial Prevention &
Reimbursement Resolution

Hold Payers Accountable

Overturn Denials
Optimize Reimbursement

Reduce denials by ensuring medical necessity appropriateness to increase reimbursement revenue. Our denial management physician advisors utilize medical judgement in conjunction with our proprietary payer database to reinforce revenue integrity and recover reimbursement.

Doctors and physician advisor discussing case
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    Reduce Initial Denials

    Continual communication between the hospital utilization management team and our physician advisors

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    Address Claim Denials

    Advocating for change in status or reconsideration

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    Reclaim Revenue Earlier

    Reduce the number of initial denials to avoid delays in the revenue cycle

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    Recover Reimbursement Revenue

    Hold payers accountable and get paid for the care you provide.

Payer Peer-to-Peer Reconsideration Reviews

Submission deadlines and lack of resources shouldn't prevent you from resolving medical necessity before the claim is submitted. Recoup dollars by getting appeals overturned to increase reimbursement revenue.

Appeal Reviews

Our physician advisors review denied inpatient stays and recommend appeals when appropriate. 

AppriseMD Return on Investment

Return on Investment

Our hospital clients see positive ROIs with our Payer Peer-to-Peer Reconsider Review offering, typically in excess of 4x! Our dedicated denial management team takes the burden off of hospitals, facilitating the entire process to ensure that the  reconsideration review period is maximized, allowing our hospital partners to reclaim revenue earlier.

Proprietary Payer DatabaseOur payer database is continually updated to reflect payer trends, tactics and policies, as well as key factors that play into how payer medical directors make determinations.

Optimize Revenue CycleIncrease cash flow by taking advantage of the reconsideration review period by initiating a payer peer-to-peer. These are the closest thing to a gift that a hospital can expect, so take advantage of this opportunity.

Ensure Revenue IntegrityHold payers accountable and fight back. Contact us today to learn how you can achieve a positive ROI by challenging denials.

Dealing with Denials

Ultimately hospitals and other healthcare providers can no longer ignore the impact inpatient denials can have on their cash flow. Ninety percent of all denials are preventable, so why aren’t more denials being prevented?

A compendium of research compiled by


Optimize patient care, reduce denials and maximize reimbursement through our unique approach to achieving excellence in utilization management.

Discuss your hospital’s utilization and denial management needs with our team.


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