Overview
Appeals from Agile Nexus Solutions – handled by experienced US medical billing specialists, with clear reporting every month.
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Appeals
Practices with denied claims that should have been paid.
Who it's for
Practices with denied claims that should have been paid.
How we do it
- 1We review the denial, the payer policy and the medical record.
- 2We write a clear appeal letter citing the payer policy and coding rules.
- 3The appeal is filed with supporting records within the payer’s deadline.
- 4We follow up through each appeal level until there is a final decision.
Frequently asked questions
Which denials are worth appealing?
Denials where the service was covered, documented and coded correctly, such as medical necessity, bundling or authorization denials with proof.
Do you handle second-level and external appeals?
Yes. We follow each payer’s appeal levels, including reconsideration and redetermination for Medicare.
Do you need anything from the provider?
Sometimes a signed letter of medical necessity or extra records. We prepare the draft so the provider only needs to review and sign.