Professional Claim Denial Solutions

Complex denials require expert handling. Our team has the medical coding knowledge and insurance experience to win difficult appeals.

Turn Your Denied Claims Into Cold Hard Cash

Healthcare providers lose millions every year to claim denials. You work hard to care for patients, but insurance companies make it nearly impossible to get paid what you deserve. Sound familiar?

At Core One Med, we fix this problem. Our denial management team fights for every dollar you’ve earned. We know exactly which buttons to push and which arguments work with each insurance company.

Get help with your cardiology billing now. Call us today at Call 949-507-3011

Stop Losing Money to Stubborn Insurance Companies

Imagine you treat a patient, submit the claim, and BAM. Denied. Again.

The insurance company gives you some vague reason about “medical necessity” or “prior authorization.” Meanwhile, your bills keep piling up and your staff spends hours on hold trying to figure out what went wrong.

Here’s the truth most providers don’t want to admit: You’re probably leaving 15-30% of your revenue on the table because denied claims never get appealed properly.

Connect with us for billing help. Call 949-507-3011

We Turn "No" Into "Yes" (And Cash in Your Bank Account)

Our denial management specialists have seen every trick insurance companies use. We speak their language and know their weak spots.

When a claim gets denied, we don’t just resubmit it and hope for the best. We dig deep, find the real problem, and build an airtight case that’s impossible to ignore.

Here’s what happens when you work with us:

Why Most Denial Appeals Fail (And How We Win)

Most practices handle denials all wrong. They assign the task to whoever has free time, cross their fingers, and hope something sticks. That’s like bringing a butter knife to a sword fight.

Insurance companies count on you giving up. They make the process so frustrating that 67% of denied claims never get appealed at all. Free money for them, lost revenue for you.

We play by different rules.

Our Battle-Tested Denial Fighting System

Step 1: The Detective Work

We don't guess why your claim got denied. Our team pulls apart every detail, checks coding accuracy, reviews medical records, and identifies the exact problem. Most denials happen for predictable reasons once you know what to look for.

Step 2: The Strategic Strike

Each insurance company has different hot buttons. Aetna responds to one type of argument, while Blue Cross needs something completely different. We've mapped out these patterns over thousands of successful appeals.

Step 3: The Follow-Through

Here's where most practices fail. They submit an appeal and wait. We track every claim, follow up relentlessly, and escalate when needed. Squeaky wheels get paid.

Denial management that actually recovers your money. Core One Med’s specialists have seen every denial trick insurance companies use. Call 949-507-3011 today.

The Hidden Costs of DIY Denial Management

Your front desk staff makes $18 per hour. How much time do they spend on denied claims each week? 10 hours? 15 hours?

That’s $270-$405 per week just in labor costs. Add up the opportunity cost of what else they could be doing, and you’re looking at serious money.

Meanwhile, the average denied claim is worth $312. If your staff successfully appeals just one out of every five claims they work on, you’re barely breaking even.

We flip those numbers upside down.

What Makes Core One Med Different

Other companies treat denial management like a numbers game. Submit enough appeals and some will stick. That’s amateur hour.

We treat each denial like a puzzle that needs solving. Our specialists have medical coding certifications, insurance industry experience, and a track record that speaks for itself.

Our secret weapons:

Stop wasting staff time on hopeless appeals. Core One Med handles everything while you focus on patients. Call 949-507-3011 to get started.

The Money You're Missing Right Now

Take a look at your practice management system. How many claims from the last six months show “denied” status?

Multiply that number by your average claim amount. Now multiply by 0.73 (our average recovery rate for previously denied claims).

That’s real money sitting there waiting to be collected. Money that could pay for new equipment, staff bonuses, or your kid’s college fund.

Ready to claim what’s yours? Call 949-507-3011 now and let’s start recovering those lost dollars. Every day you wait is money walking out the door.

The Real Cost of Doing Nothing

Let’s do some quick math. If your practice generates $100,000 per month in claims and 20% get denied, that’s $20,000 in potential lost revenue every single month.

Without proper denial management, you might recover $6,000 of that through basic resubmissions. The other $14,000? Gone forever.

Over a year, that’s $168,000 walking out your door. Enough to hire another provider, upgrade your entire IT system, or take that vacation you’ve been putting off for three years.

How Fast Can You See Results?

Most practices see improvements within the first billing cycle. Here’s what typically happens:

What Happens During Your Free Consultation

When you call (949) 507-3011, here’s exactly what we’ll do:

Quick Practice Assessment

We'll ask about your current denial rates and biggest pain points

Revenue Recovery Estimate

Based on your numbers, we'll show you realistic recovery projections

Custom Action Plan

We'll outline specific steps to fix your denial problems

No-Pressure Discussion

We'll answer your questions and let you decide if we're a good fit

The whole conversation takes about 15 minutes. No sales pitch, no high-pressure tactics. Just straight talk about your money.

Your Next Move

You have two choices right now:

The choice seems pretty obvious to us.

Don't Wait Another Day

Every denied claim that sits unworked is money slipping away. Insurance companies have deadlines for appeals. Miss those deadlines and your money is gone forever.

Call Core One Med at 949-507-3011 right now. Our denial management specialists are standing by to review your situation and show you exactly how much revenue we can recover.

Your practice deserves every dollar it earns. Let’s make sure you get it.

Core One Med – Because your revenue shouldn’t depend on insurance company mood swings.

Frequently Asked Questions

Denial management services help healthcare providers investigate, analyze, and resolve insurance claim denials. When insurance companies refuse to pay for medical services you’ve provided, denial management specialists step in to fight for your money. These services include identifying why claims got denied, fixing the problems, submitting appeals, and putting systems in place to prevent future denials. The goal is simple: get you paid for the work you’ve already done.

The three main types of denials in medical billing are technical denials, clinical denials, and coverage denials. Technical denials happen because of administrative errors like missing patient information, incorrect demographics, or invalid codes. Clinical denials occur when insurance companies question whether a treatment was medically necessary or meets their coverage requirements. Coverage denials happen when the patient’s insurance plan doesn’t cover the specific service or treatment you provided.

RCM denial refers to claim denials within the Revenue Cycle Management process. These denials are classified as either soft or hard denials. Soft denials have minor technical errors that are easy to fix and can be resubmitted with corrections. Hard denials involve more serious issues like missing prior authorization, services not covered by the plan, or late filing, and typically require formal appeals. Understanding RCM denials helps practices manage their entire billing workflow more effectively.

A denial code is a specific identifier that explains why an insurance company rejected your claim. For example, denial code A1 means the claim lacks a necessary remark code. These codes help billing staff understand exactly what went wrong so they can fix the problem and resubmit the claim. Each insurance company uses standardized codes to communicate denial reasons, making it easier to track patterns and address recurring issues.

Managing denials requires a systematic approach. First, carefully review the denial notice to understand why the claim was rejected. Next, gather all necessary supporting documentation like medical records, prior authorizations, or corrected coding information. Then submit a detailed appeal letter along with the supporting documents. The key is acting quickly since most insurance companies have strict deadlines for appeals. Track every denial, follow up regularly, and look for patterns that might indicate bigger problems in your billing process.

Accounts Receivable (AR) in medical billing represents money that patients and insurance companies owe you for services you’ve already provided. It’s essentially your outstanding invoices waiting to be paid. AR includes everything from the moment you submit a claim until you receive payment. Managing AR effectively means tracking aging reports, following up on overdue accounts, and ensuring claims move through the payment process quickly. Good AR management keeps cash flowing into your practice.

AR and denial management work together but focus on different parts of your revenue cycle. 

AR management tracks all money owed to your practice and ensures timely collection of payments. It’s about managing the entire accounts receivable process from claim submission to final payment. 

Denial management specifically focuses on claims that insurance companies have rejected or denied. While AR looks at the big picture of money flow, denial management zooms in on fixing specific problems that prevent you from getting paid. Both are essential for maintaining healthy cash flow in your practice.

Need help with your denials? Call Core One Med at 949-507-3011 and let our specialists recover the money you’re owed.