Win More Appeals. Recover More Revenue.

Denials Don’t Have to Mean Lost Income. OneMed's Appeal Management
ensure timely, well-documented, and payer-specific appeals that maximize overturn success and recover revenue that’s rightfully yours.

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Upto 70% Appeal Success Rate

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Reduced Reprocessing Time

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Expert Appeals for All Payers

Denied Doesn’t Mean Done

Appeals are your final opportunity to secure rightful reimbursement, but success depends on expertise, urgency, and precision. Whether the denial is due to missing documentation, questions of medical necessity, or payer misinterpretation, OneMed converts denials into revenue through a structured and strategic appeal process.

We manage every step, from identifying appealable denials to crafting strong, compliant arguments and submitting the necessary documentation. This ensures faster resolution and maximum recovery. Appeals are your final opportunity to secure rightful reimbursement, but success depends on expertise, urgency, and precision. Whether the denial is due to missing documentation, questions of medical necessity, or payer misinterpretation, OneMed converts denials into revenue through a structured and strategic appeal process.

We manage every step, from identifying appealable denials to crafting strong, compliant arguments and submitting the necessary documentation. This ensures faster resolution and maximum recovery.

Types Of Appeals in Medical Billing

In medical billing, there are three common scenarios when an appeal can be filed. The first is when the insurance plan refuses to pay for the claim. The other two situations are when the health insurance claims the patient isn’t eligible for coverage or ends their coverage.

State of the Art Appeal Management Services by OneMed Billing

Appeal Management is a critical component of medical billing. It actually determines the amount of reimbursement a provider will receive from the insurance payer. It is important that this process is carried out by an experienced team of charge entry specialists who knows how to enter the correct charges from the coded documents accurately.
Charge Abstraction is the first step in the process of medical billing and a crucial component of Revenue Cycle Management. It starts with meticulously recording every service rendered to the patient, verifying it with the Fee Schedule, and finally forwarding all data for creating the final claim.

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Our Appeal Management Workflow

Step 1: Denial Identification

Review denials from clearinghouses or payer EOBs

Step 2: Root Cause and Appeal Viability Check

Evaluate coding, documentation, or policy discrepancies

Step 3: Documentation Gathering

Collect all necessary records, such as clinical notes, operative reports, referrals, and medical necessity proof

Step 4: Appeal Drafting and Submission

Draft customized appeal letters with references to payer policies

Step 5: Follow-Up and Resolution

Monitor appeal status and follow up consistently until a decision is received

Our Appeal Management Workflow

1

Denial Identification

  • Review denials from clearinghouses or payer EOBs
  • Analyze reason codes and determine appeal eligibility

2

Root Cause and Appeal Viability Check

  • Evaluate coding, documentation, or policy discrepancies
  • Confirm if the denial qualifies for appeal and define the strategy

3

Documentation Gathering

  • Collect all necessary records, such as clinical notes, operative reports, referrals, and medical necessity proof
  • Ensure all materials meet the payer’s appeal criteria

4

Appeal Drafting and Submission

  • Draft customized appeal letters with references to payer policies
  • Submit appeals electronically, by fax, or through postal mail, depending on payer requirements

5

Follow-Up and Resolution

  • Monitor appeal status and follow up consistently until a decision is received
  • Escalate to second-level appeals or peer reviews when needed

Types Of Appeals in Medical Billing

Experienced Appeal Writers

  • Our appeals team combines clinical, coding, and compliance knowledge to create compelling and compliant appeal letters.

Quick Action, Better Results

  • We act quickly to meet payer timelines, which helps reduce the risk of missed deadlines and revenue loss.

Multi-Level Appeals Support

  • We manage the entire appeal process, including first-level, second-level, and external reviews.

Detailed Appeal Logs and Reports

  • We offer real-time tracking, regular status updates, and denial trend reports to support continuous process improvement.

WhyOneMed BIlling is Your Ideal Appeals Partner

Want to eliminate payment posting errors and accelerate your revenue cycle?