Denial Management System
Dashboard with denial reason tracking, automated follow-up queues at 7 and 14 days, payer-specific appeal workflows, and denial trend reporting by CPT code and provider.
I build the automation layer between your billing, coding, credentialing, and collections — so your team manages exceptions, not volume.
Most practices I speak with have at least one area quietly draining time or revenue. Sometimes it's denial rates creeping up because claims are going out with coding errors nobody caught. Sometimes it's credentialing — a provider sitting in payer enrollment limbo for six weeks while the practice can't bill for their work. Sometimes it's AR: the follow-up queue is a spreadsheet, the 7-day and 14-day touchpoints depend on someone remembering, and the aging report is a number nobody fully trusts.
None of it is catastrophic alone. Together it compounds. And the fix is rarely more staff — it's a system that handles volume so staff can handle complexity.
Dashboard with denial reason tracking, automated follow-up queues at 7 and 14 days, payer-specific appeal workflows, and denial trend reporting by CPT code and provider.
Provider enrollment status by payer, re-credentialing calendar alerts, CAQH update reminders, and a dashboard showing which providers are billable and which are pending.
Automated follow-up triggers on outstanding claims, patient balance notifications, payer-specific AR rules, and aging dashboards showing exactly where your 60+ day buckets are building.
Pre-submission claim review layer, coding error flags before clearinghouse submission, modifier audit trails, and integration with your existing EHR or PM system.
Real-time view of collection rates by payer, denial rates by provider and code, days in AR, and net collection rate — all in one place without exporting to Excel.
API integrations with eClinicalWorks, athenahealth, Kareo, AdvancedMD, and major clearinghouses. Your existing systems stay; I add the automation layer on top.
I haven't published a healthcare case study yet — I'm building toward that with my first engagements. What I have: CRM pipelines with claim-like status tracking and retry logic, role-based access systems that mirror HIPAA minimum-necessary requirements, automated AR follow-up queues from other industries, multi-entity platforms where financial data stays properly separated. The systems are the same. The domain is new.
First healthcare engagement: referral-rate pricing and a published case study in return.
Currently booking projects · reply within 24h · Pick what feels lowest-friction.