Denial Management that works as hard as you do.
Many denied claims are never reworked, which means that revenue is simply written off. Nexra Connect works every denial: we categorize it, fix and resubmit or appeal it, and trace it to the root cause. Then we change the process upstream, whether that is eligibility, authorization, coding or documentation, so your denial rate keeps falling.
What's included
- Denial categorization by CARC/RARC code
- Corrected claim resubmissions
- First- and second-level appeals
- Medical records and letter of medical necessity support
- Underpayment and contract variance recovery
- Payer escalation and provider rep outreach
- Root-cause analysis and trend reporting
- Front-end process fixes
- Timely filing and appeal deadline tracking
- Medicare redeterminations and reconsiderations
Recover written-off revenue
Denials that would have been abandoned are appealed and paid.
Prevent repeat denials
Root-cause fixes stop the same denial reason from showing up next month.
Meet every deadline
Appeal windows are tracked by payer so nothing expires unworked.
See the patterns
Denial trend reports show exactly which payers, codes and providers need attention.
How we deliver denial management.
Identify & categorize
- Denials captured from ERAs daily
- Grouped by reason code and payer
- Prioritized by dollar value and deadline
- Assigned to a specialist the same day
Analyze root cause
- Front-end vs. back-end cause determined
- Documentation reviewed for support
- Payer policy checked for changes
- Contract terms reviewed for underpayments
Correct or appeal
- Corrected claims resubmitted
- Appeal letters written with clinical support
- Medical records attached as needed
- Peer-to-peer requests coordinated
Track to resolution
- Appeal status monitored
- Second-level appeals filed when needed
- Payer escalations for stalled appeals
- Outcome recorded for trend analysis
Prevent
- Monthly denial trend report
- Process fixes at registration and coding
- Payer rule updates shared with your team
- Denial rate tracked month over month
The partner behind your revenue.
- Every denial is worked, not just the large ones
- Appeal letters written by experienced specialists
- Root-cause reporting you can actually act on
- Medicare appeal process expertise
- Prevention-focused, so your denial rate falls over time
Denial Management questions, answered.
What are the most common reasons claims are denied?
The most common causes are eligibility and coverage issues, missing prior authorizations, coding and modifier errors, missing documentation for medical necessity, duplicate claims and timely filing. Most of these can be prevented upstream.
Can you work denials that are already old?
Yes, as long as the appeal or corrected-claim window is still open. During onboarding we review your open denials and prioritize them by deadline and value.
Do you handle Medicare appeals?
Yes. We handle redeterminations and reconsiderations, and we prepare documentation for higher levels of appeal when the claim warrants it.
Can we buy denial management on its own?
Yes. Denial management is available as a standalone service or as part of full revenue cycle management.