Service guide
Denial Management Services
The short answer
Nine firms state denial management services on their own sites, listed alphabetically with no rankings. Below: what the service includes and when to outsource it.
Every practice gets denials. The question is whether someone is systematically working them or whether they are quietly becoming write-offs. Denial management is the discipline of categorizing denials, fixing root causes, appealing what should pay, and preventing repeats.
Most practices under-invest here because denials feel like a back-office nuisance. They are actually a revenue diagnostic: your denial patterns tell you exactly where your front-end process is broken.
Nine firms in our directory state denial management services on their own websites, listed below in alphabetical order. Nothing is ranked, reviewed, or paid for. After the listings we cover what the service includes, when to outsource it, and the red flags.
Companies offering denial management
Matched by the services each firm lists on its own site. All listings are unclaimed unless marked otherwise.
13 firms listed
Outsourced medical billing company offering billing, credentialing, and denial management with revenue cycle automation.
Specialty-focused revenue cycle management: billing, coding, claims, denial management, and accounts receivable follow-up.
Sheridan, WY
Extended business office, bad-debt recovery, physician billing and coding, and denials management for hospitals and physician groups.
Lexington, KY
Multi-specialty medical billing with denial management and accounts receivable recovery, serving cardiology, nephrology, and orthopedics.
New Jersey
Orthopedics · Cardiology
Insurance follow-up, denial management, and accounts receivable work-down for hospitals and physician groups.
Duluth, GA
Medical billing company offering billing, enrollment, eligibility verification, and denial management; serves rehab, behavioral health, and urgent care.
Behavioral Health
Medical billing company serving practices across many specialties, with charge entry, coding, accounts receivable follow-up, and denial management.
Billing and coding, denial management, accounts receivable recovery, and prior authorization.
St. Petersburg, FL
Receivables, denials, and revenue cycle management services.
Tampa, FL
End-to-end billing, coding, eligibility, denials, accounts receivable, and credentialing across 15+ specialties.
Brentwood, TN
Orthopedics · Cardiology · Pediatrics
Full-cycle revenue cycle management including denials, audits, and credentialing for independent and multi-specialty practices.
Texas
Medical billing company providing comprehensive billing, coding, and denial management, and end-to-end revenue cycle management.
End-to-end revenue cycle management, denial management, physician billing, accounts receivable recovery, and coding.
Dalton, GA
9
firms in our directory stating denial management services
Source: BillingFirms directory data (verified 2026-10-01)
11.8%
average first-pass claim denial rate
Source: Kodiak Solutions
<5%
denial-rate target for top-performing practices
Source: MGMA best-practice benchmarks
What denial management actually includes
Real denial management has four parts: categorizing every denial by cause, appealing denials that should have paid, fixing the root causes upstream, and reporting trends back to you. The appeal work is the visible part. The root-cause work is where the lasting value lives.
Payer-specific knowledge matters enormously. Each payer denies differently and each has different appeal deadlines and processes. A vendor needs playbooks per payer, not just a generic appeal letter template.
When to outsource denial management
Consider outsourcing when your denial rate sits above 5 percent, when aging A/R over 90 days keeps growing, or when your staff appeals the easy denials and writes off the rest. Those are all signs the function needs dedicated attention your team cannot give it.
It also makes sense after growth spurts, new payer contracts, or EHR changes, all of which spike denial rates temporarily. A vendor that has seen these transitions before stabilizes things faster than a team learning on the job.
Appeals versus prevention
Appeals recover revenue on individual claims. Prevention fixes the eligibility checks, authorization workflows, and coding habits that created the denials. You need both, but prevention compounds while appeals do not.
When evaluating vendors, ask how they feed denial findings back into your front-end process. A vendor that only reworks denials without changing what caused them will keep you as a customer forever, which should tell you something about their incentives.
Red flags in denial management vendors
Watch for these warning signs when evaluating a denial management service.
- No root-cause analysis. If they only appeal and never fix upstream causes, denials will never decline.
- No payer-specific reporting. You should see denial rates and overturn rates broken out by payer.
- Appeal deadlines missed. Every payer has filing limits, and a vendor that misses them is worse than no vendor.
- No prevention feedback loop. Findings should change your front-end process, not just fill an appeal queue.
Frequently asked questions
What does denial management cost?
Denial management is often bundled into a billing company's percentage of collections, commonly 4 to 10 percent. Standalone denial services may charge a percentage of recovered revenue or a flat monthly fee. Ask whether prevention work and reporting are included, since appeal-only services cost less and deliver less.
What is a good denial rate for a medical practice?
Top-performing practices keep denial rates below 5 percent, according to MGMA best-practice benchmarks. The industry average for first-pass denials is around 11.8 percent per Kodiak Solutions data. If your rate sits above 5 percent, there is meaningful revenue to recover through systematic denial work.
What is the difference between denial management and A/R follow-up?
Denial management focuses on denied claims: why they denied, how to appeal them, and how to prevent repeats. A/R follow-up is broader, covering all unpaid claims including those stuck in processing or awaiting payer action. The two overlap heavily, and many vendors offer both as a combined back-end service.
How long do practices have to appeal a denied claim?
Appeal deadlines vary by payer and by plan, commonly ranging from 60 days to a year from the denial, with Medicare and many commercial payers on the shorter end. Missing the window forfeits the revenue permanently. Any denial vendor should track appeal deadlines per payer as a basic operational function.
Can denial management actually lower our denial rate?
Yes, when it includes root-cause work. Vendors that categorize denials, fix the eligibility, authorization, and coding problems upstream, and report trends typically drive denial rates down over several months. Vendors that only appeal individual claims recover some revenue but leave the rate unchanged.
How this list was made
Firms on this page are matched from the BillingFirms directory's verified data. A firm appears when denial management services are stated in the firm's own name or public description, matched by our service keywords. Listings are alphabetical. Nothing is ranked, reviewed, or vetted, and no firm currently holds a Featured placement.
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