The average practice leaves $250,000+ per year on the table through unmanaged denials. Probiz doesn't just appeal — we eradicate the root causes so the same denial never happens twice.
Each denial type requires a different resolution strategy. Our team is trained in all of them.
Patient insurance was inactive, wrong plan ID, or coverage wasn't verified pre-service. We catch this before the claim is ever filed.
Service required pre-approval that wasn't obtained. We manage all authorization workflows proactively, so services are always pre-cleared.
Incorrect CPT, ICD-10, or modifier usage. Our certified coders conduct pre-submission audits to catch every error before it reaches the payer.
Payer determined the service wasn't clinically justified. We build clinical appeals with supporting documentation that speaks the payer's language.
Claim filed more than once or system generated a duplicate. Our tracking system prevents any duplicate from reaching submission stage.
Claim submitted past the payer's deadline. We track all filing deadlines per payer and guarantee every clean claim is submitted within window.
Speed and precision win appeals. Our structured pipeline delivers a High overturn rate on first submission.
Every denial flagged within one business day of payer response
Denial code analyzed against patient record, payer policy, and claim history
Clinical appeal letter crafted with supporting documentation
Submitted via optimal channel (EDI, portal, certified mail) within payer deadline
Data fed back into prevention model to stop recurrence
Reactive denial management is treating symptoms. Our intelligence-led approach targets the root causes upstream — before a single claim is submitted.
Every patient's coverage confirmed before service — automatically.
Our rules-based pre-submission engine catches payer-specific conflicts before they become denials.
Our team tracks payer LCD/NCD updates monthly to stay ahead of rule changes.
Custom analytics showing denial sources, rates, and improvement over time.
We combine certified expertise with proprietary technology to deliver unmatched revenue cycle performance.
Our advanced rules-based scrubbing engine runs every claim against millions of payer-specific rules before submission, practically eliminating front-end rejections and accelerating your cash flow.
We don't use generalists. Your account is managed by specialty-specific certified coders who understand the nuances of your exact clinical discipline, ensuring maximum compliant reimbursement.
Stop waiting for end-of-month reports. Our proprietary BI dashboards give you real-time visibility into collection rates, A/R aging, and denial trends.
We work seamlessly within your existing software via secure, HIPAA-compliant VPNs. Zero data migration required, and zero disruption to your clinical workflow.
Switching billing partners shouldn't disrupt your cash flow. Our meticulously engineered onboarding process ensures a smooth, parallel transition.
We establish secure remote access to your EHR/PMS and map your existing workflows without interrupting your current team.
We audit your past claims to identify immediate revenue leakage, coding errors, and systemic denial trends.
Our rules-based scrubbing engine is programmed with your specific payer matrix and local coverage determinations to prevent future denials.
We take over day-to-day operations, instantly applying our optimized workflows to accelerate your cash flow and reduce days in A/R.
Common questions about our process, integration, and security.
Let us run a complimentary denial audit on your last 90 days of claims. We will show you exactly what you've lost and how we'll get it back.
