tci Medicare Compliance & Reimbursement - 2009 Issue 12
APPEALS :Add Up How Many Low-Dollar Denials You Write Off and Determine Whether to Pursue Payment
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Article Overview
This article explains a denials-management approach for physician practices that want to understand whether low-dollar write-offs are costing them money. It covers the difference between formal appeals and simpler claim corrections, how to assess the cumulative impact of underpayments, and practical considerations for tracking and managing appeal activity. The piece is aimed at billing, coding, reimbursement, and practice management staff who oversee denial follow-up and revenue recovery.
Why This Topic Matters
Small denials can add up over time, so practices that only look at individual claim amounts may miss meaningful revenue leakage. Understanding when a claim needs a formal appeal, when a payer call may be enough, and how to track volume-based denial patterns can improve collection performance.
What You Will Learn
- How practices can evaluate whether low-dollar denials are worth pursuing
- How appeal activity differs from simpler claim correction workflows
- How denial patterns and underpayments can be tracked at the practice level
- How teams can organize follow-up work to avoid wasted appeal effort
Who Should Read This
- Medical billing staff
- Coders
- Reimbursement specialists
- Practice managers
- Revenue cycle teams
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