Appeal Management

Clinical denial backlogs happen, but we’re here to help. Advent Health Partners’ flexible model allows us to supplement your denial management team when, where, and as you need it.

Our team’s clinical expertise and payer backgrounds deliver correctly appealed denials focused on claims with overturn potential. Learn more about Advent’s 91+% appeal recovery rate in this video.

Sample Appeals

Our appeal letter structure is at the core of our 91+% appeal recovery rate. Writing an appeal is an art form, and crafting an organized and compelling appeal letter is key. Check out an example of a medical necessity appeal letter below to see our structure and best practices.

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Why Use Advent for Your Appeal Management

Flexible Partnership

Advent flexes to your needs regarding services, admission types, and volume of cases.

Clinical Expertise

Our dedicated team of RNs have experience in several specialized fields including cardiology, NICU, PICU, oncology, and wound care. This ensures that we can provide a comprehensive level of service to your organization based on your individual needs.

Comprehensive Defense

In the unlikely event of a denial, Advent defends our work throughout the life of the claim at no additional cost.

Improving Denial Rates with Appeal Management & Pre-Bill Reviews

What Makes Advent Different?

  • Monthly Status Report

Details your claim inventory status, providing a claim roll-up of the activity taken on the claims, where they currently reside in the process, and final claim resolution.

  • Executive Summary

Overviews metrics for designated period and may show trends not easily seen within the project. Helps escalate any issues or opportunities for both Advent and client.

  • On-Trend Report

Case-by-case review to determine appeal opportunities. Aggregates and outlines the story of your denials plus our recommendations for addressing root causes.

  • Standard Graph

Illustratively depicts claims appealed and recovery results. Specific graphs can include appealed amounts by payer and/or denial type plus closures by reasons and/or payers.

Revenue Integrity Consulting Solutions

Need help identifying root cause trends for your organization’s denials? Our revenue integrity solutions team identifies root cause trends for your organization’s denials and delivers actionable recommendations. As a single vendor solution, Advent provides optional implementation assistance so your team can leverage these strategies – and results – immediately.

Looking to uncover the challenges and identify the gaps within your business?

Please submit the form below to book a meeting with an Advent Health Partners expert.