Denial Recovery

82% of appealed denials
get overturned.
Most practices never appeal.

Denied claims aren't final — they're a negotiating position. The problem is that fighting denials takes time most billing companies won't spend. At Evident RCM, we pursue every denial because we know what's actually collectible.

Get a Free 90-Day Denial Audit
82%
Of appealed denials are ultimately overturned by payers
11%
Of eligible denied claims are ever appealed by the practice
65%
Of denied claims are never reworked at all — abandoned entirely

Why denials get abandoned

The economics of a typical billing company work against you. Chasing a complex denied claim can take 30–60 minutes of staff time to net $5–10 on a $100 claim. So the hard claims — the high-value, complex cases that are most frequently denied — get quietly written off.

For orthopedic, pain management, and spine practices, this is especially damaging. The procedures that get denied most often — spinal cord stimulator implants, RFA, SI joint fusions, complex operative cases — are also your highest-revenue procedures. The cases your billing company abandons are the exact cases where the most money is at stake.

1

Denial identification within 24 hours

Every denial is logged, categorized by reason code, and routed to our denial management team the same day it arrives.

2

Root cause analysis before appeal

We determine whether the denial is a coding issue, documentation gap, authorization failure, or payer error — and build the appeal accordingly.

3

Peer-to-peer review coordination

For clinical necessity denials, we coordinate peer-to-peer reviews between your physician and the payer's medical director.

4

Escalation through all appeal levels

We don't stop at first-level appeals. We pursue second-level, external review, and IDR when the case warrants it.

Free Audit

We'll audit 90 days of your denied claims — at no cost.

Most practices don't know how much they're leaving behind. We'll pull 90 days of denial data, identify recoverable revenue, and give you a specific dollar figure — before you commit to anything.

Request Your Free Denial Audit