Practices: the free denial review continues below. Device makers: start here.
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Find Out What Your Write-Off Pile Is Worth
Small denials take 45 minutes to work, so they get written off. Upload 90 days of them. See what was winnable.
See a finished review first
- No patient data
- No BAA
- No charge
- No pitch
Denials we work
Every code in your export is classified against payer rules and filing windows.
Read how each denial code works on its own page.
- CO 197
Prior Auth Absent
Precertification, authorization or notification was missing.
Click to learn more - CO 50
Medical Necessity
The payer judged the service not medically necessary.
Click to learn more - CO 16
Missing Information
The claim lacks information the payer needs to decide it.
Click to learn more - CO 97
Bundled Service
Paid as part of another service on the same claim.
Click to learn more - CO 96
Non-Covered Charge
The charge is not covered under the payer's rules.
Click to learn more - OA 23
Prior Payer
The amount reflects what a prior payer already decided.
Click to learn more - PR 204
Not Covered by Plan
The service is not covered by the patient's current plan.
Click to learn more - CO 109
Wrong Payer
The claim went to the wrong payer or contractor.
Click to learn more - CO 151
Units Not Supported
The payer says the records do not support this many units.
Click to learn more - CO 29
Filing Limit
The time limit for filing the claim has expired.
Click to learn more - CPT 27278
SI Joint Fusion Coverage
Which commercial payers cover minimally invasive SI joint fusion, with sources.
Click to learn more - E0483
HFCWO Vest Coverage
Which commercial payers cover a chest wall oscillation vest, and where they split.
Click to learn more - E0738
Upper-Limb Rehab Coverage
How commercial payers treat an upper-limb rehabilitation system, with sources.
Click to learn more
4 columns. Nothing else.
From a report your system already produces. If you can export it, you can upload it.
denials_90_days.csvThat is the whole file. Sample rows.| Payer | Denial code | Count | Billed |
|---|---|---|---|
| Aetna | CO 197 | 14 | $8,420 |
| UnitedHealthcare | CO 50 | 6 | $9,100 |
| Cigna | CO 16 | 11 | $3,300 |
We do not want patient data and we do not need it. No names, no member IDs, no dates of birth, no dates of service. If your file contains any, the upload is refused on the spot and we name the column. It is never stored.
3 Steps. About a Minute.
Here is how the free review works:
- 1Upload 4 columnsA standard export from your practice management system. Payer, denial code, count, billed amount.
- 2Every code is classifiedAgainst payer rules and filing windows, from the rows you sent. Nothing is estimated.
- 3One page, straight awayWhat is winnable, what is already lost, what needs a clinician, and the dollars behind each.
What You Get Back
One page, sorted by what you can actually do.
Winnable now
Recoverable denials by payer and reason code, and what they add up to.
Already lost
Past the filing window, or really a contractual write-down. No point chasing it.
Needs a clinician
Winnable on the merits, but somebody has to attest to medical necessity.
Every figure is computed from the rows you send. Nothing is estimated, and where we are unsure about a code we say so rather than guessing.
Why Is This Free?
See a sampleThere is no catch, and here is the reason.
Your export shows us which denials cost practices the most. The review shows you what is recoverable. You keep the answer, whether you buy or not.
Start with a free review of your denials. If the numbers hold up, we agree terms with you after the review. No subscription to sign up front. How it works and how you start.
- The review first, at no charge
- No subscription to sign up front
- Your people approve every appeal
Before You Upload
One client, 90 days, 4 aggregate columns. You get back what was winnable and what it was worth.
Upload your denial export- No patient data. 4 aggregate columns, nothing else.
- PHI is refused, not stored. The upload stops and we name the column.
- Held in the United States. Deleted whenever you ask.
- No account, no card, no contract. What ships today, and what does not.
Start Your Free Denial Review
Every denial worked, not just the ones worth the time.
Payer, denial code, count, billed amount. If you can export it, you can upload it.
Your Questions Answered
What do I need to send?
A standard export from your practice management system with 4 columns: payer, denial code, count and billed amount. If you can export it, you can upload it.
Do you need patient data?
No. No names, no member IDs, no dates of birth, no dates of service. If your file contains any, the upload is refused on the spot and we name the column. It is never stored.
What comes back?
One page, straight away: what is winnable, what is already lost, what needs a clinician, and the dollars behind each. Where we are unsure about a code we say so rather than guessing.
Why is the review free?
Your export shows us which denials cost practices the most. The review shows you what is recoverable. You keep the answer, whether you buy or not.
What does AppealHound cost after that?
Start with a free review of your denials. If the numbers hold up, we agree terms with you after the review. No subscription to sign up front.
Where do I find this export in my system?
Any report that lists denials by reason code works: a denial summary, an adjustment report grouped by CARC, or an ERA/835 summary. If it has payer, denial code, count and amount, it works. Stuck? Email us the column names and we tell you which report to pull.
My report is in Excel. Is that a problem?
Save it as CSV first. In Excel: File > Save As > CSV UTF-8. In Google Sheets: File > Download > CSV. If you upload the Excel file, the page tells you the same.
Is the recoverable number real or an estimate?
Every figure is computed from the rows you send. Nothing is estimated. The classification is our own reading of each code, and codes we are unsure about are shown separately and not counted.
Does it work for commercial payers, or only Medicare?
The review works for any payer, because it reads the denial code. For Medicare we cite CMS national coverage policy. For commercial payers we look up the payer's published policy where we have it, and we say so when we do not. We do not cite local coverage (LCD) policies yet.
Do we have to change our practice management system?
No. There is no integration. You upload the 835 or an export your system already produces.
Will you contact our payers or our patients?
No. Your person approves and sends every appeal, on your rail and your letterhead. We never contact patients.
What about medical necessity denials?
They are flagged “needs a clinician”. The appeal is prepared, but somebody clinical has to attest before it goes out. Nothing is sent without it.
Who is behind AppealHound?
Vantar Group LLC, a US company in Sheridan, Wyoming. Your data is stored in the United States. One person reads every message to malte@appealhound.com.