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Denial Management Services

Root cause analysis, aggressive appeals, and process fixes. Average denial rate reduction of 14% within 30 days.
The RCMBillers Difference

Stop denials before they happen. Fix the ones that do.

The national average denial rate is 11.1%. The top practices we work with sit below 3%. Our denial management team does two things simultaneously: appeal every current denial aggressively, and fix the root causes so the same denials stop happening. Within 30 days, most clients see measurable improvement.

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14%Avg reduction in 30 days
3%Target denial rate
60%Claims practices never refile
$0Revenue written off without appeal

What's included

Root Cause Analysis

Every denial categorized by reason code, payer, and provider to identify patterns.

Aggressive Appeals

We appeal every denial before the filing deadline. No exceptions.

Payer Escalation

Peer-to-peer review requests and escalation for complex denials.

Front-End Prevention

Process changes to prevent the same denials from recurring.

Eligibility Denial Prevention

Real-time eligibility checks to prevent the #1 cause of denials.

Denial Trend Reporting

Monthly denial analysis report with trends and recommendations.

Our Process

How we onboard your practice

From signed agreement to first claims submitted — we move fast. Most practices are fully live within 5 business days.
1

Discovery Call

We learn your specialty, payer mix, volume, and current billing challenges. 15 minutes — no fluff.

DAY 1
2

EHR Integration

We connect to your existing EHR or PM system. No new software. No disruption. Setup in under 48 hours.

DAYS 2–3
3

Audit & Baseline

We review 30 days of prior claims, identify denial patterns and coding gaps, and set your performance baseline.

DAYS 3–5
4

Live Billing

First claims go out within 24 hours of your first patient day. Dashboard is live. Your account manager is reachable.

DAY 5+
Client Results

What practices say after switching

Real testimonials from real clients. Specific numbers, not vague praise.

Within 60 days our denial rate dropped from 18% to 4%. I was honestly skeptical — we had been burned by a billing company before. But the numbers don't lie. Collections are up $28,000 per month.

Dr. Michael TorresInternal Medicine, Phoenix AZ+$28K/month in collections

The onboarding was seamless. Day 5 we were live. Our previous biller took 6 weeks to get going. RCMBillers had us processing claims faster than I thought was possible.

Jennifer Choi, MBAPractice Administrator, Orthopedic Group, Seattle WALive in 5 days vs 6 weeks prior

They found $60,000 in undercoded services in the first month. No new patients, no new staff — just correct billing. I wish we had switched years ago.

Dr. Aisha PatelGastroenterology, Atlanta GA$60K found in Month 1 coding audit
Payer Expertise

We work with every major payer

From Medicare and Medicaid to commercial giants — we have established billing workflows with 500+ payers nationwide.
Medicare
Medicaid
Blue Cross
Aetna
Cigna
UnitedHealth
Humana
Tricare
Workers Comp
CHAMPVA
Molina
Centene

+ 488 more payers. If they pay claims, we know how to bill them.

Compliance & Security

HIPAA-compliant. Audit-ready. Always.

Every piece of protected health information (PHI) we handle is secured under full HIPAA compliance — administrative, physical, and technical safeguards in place at every level.

We maintain comprehensive Business Associate Agreements with every client. Our staff undergoes annual HIPAA security training, and all PHI transmission uses 256-bit encryption.

BAA with every client
256-bit encryption
Annual HIPAA training
Role-based access controls
Breach response plan
Audit-ready documentation
100%HIPAA compliance maintained
0PHI breaches in our history
256-bitSSL encryption on all data
AnnualSecurity training for all staff
Common Questions

What practices ask before switching

Most practices are fully live within 5 business days of signing. We handle EHR integration, set up your dashboard, and have your billing team briefed before your first patient day under our service.
That's up to you. Some practices transition their billing staff to front-desk or patient coordination roles. Others reduce headcount through attrition. We handle everything RCMBillers takes over — your staff can focus on higher-value patient-facing work.
No. We don't believe in locking clients in. Our agreements have a 30-day cancellation clause. We earn your business every month through results, not paperwork.
We charge a percentage of monthly collections — typically 3–5% depending on specialty, volume, and payer mix. No setup fees, no hidden charges. We only earn when you collect.
We work with all major EHR and practice management systems including Epic, Cerner, Athenahealth, eClinicalWorks, Kareo, DrChrono, Practice Fusion, NextGen, Greenway, Modernizing Medicine, and 40+ others. If you use it, we can integrate with it.
You get access to a real-time billing dashboard showing claim status, payment posting, denial rates, AR aging, and collections rate. Your dedicated account manager is also available by phone or email for any specific question.
Get Started

Ready to see results?

Request a free revenue audit and see what we can fix — and how fast.
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