High volume, low margin. Denials hit primary care hardest.
Primary care runs on volume, which means even a small denial rate adds up to real revenue. We handle the steady stream of coding and referral denials that pull your staff away from patients.
Denials we see most in primary care.
Every specialty has its own denial patterns. Here's what we typically find in primary care practices.
Preventive vs. problem-oriented coding
Annual wellness visits that surface a new issue often get partially denied when the visit is coded as purely preventive or purely problem-oriented instead of both.
Referral authorization gaps
Specialist referrals without proper prior authorization on file lead to denials that land back on the primary care practice, not the specialist.
Chronic care management billing
CCM and similar time-based codes are frequently denied for documentation that doesn't clearly show the required time and care coordination.
Duplicate visit denials
Same-day visits for unrelated issues, or visits close together for a chronic condition, often get flagged as duplicates even when clinically justified.
The same done-for-you service, built for your specialty.
We pull your denials
Connected to your billing workflow, reviewed as they come in.
AI drafts, specialists review
Every appeal is cited to payer policy and reviewed by a billing specialist before it's sent.
We handle payer follow-up
Calls and re-submissions your staff doesn't have time for.
You see what's recovered
A simple monthly report on what was appealed and what came back.
See what your primary care denials are costing you.
Send us a sample of your recent denials. We'll show you what we'd appeal and what it could recover, free.
Get my free denial audit →Frequently asked questions.
We see a high volume of small-dollar denials. Is this service worth it at that scale?
Volume-based pricing is exactly what our Growth and Performance plans are built for, individual denials are small, but the total adds up.
Can you help prevent referral authorization denials, not just appeal them?
Yes, our Prior Authorization service covers specialist referrals that require pre-approval.
Do you handle chronic care management and annual wellness visit denials?
Yes, both are common patterns we build appeals around specifically for primary care.
How fast can you turn around a high volume of small denials?
Most denials are reviewed within 1-2 business days; volume plans are scoped to your typical monthly denial count.