Denials and appeals
Every denied or short-paid line becomes a worked item. Eligibility Hub classifies it from its reason codes, chooses the remedy, builds an evidence packet from the chart, drafts the appeal letter for your review and tracks statutory deadlines. Your authorized person signs and files where the payer requires it, and we track each appeal to a decision.
At a glance
- Availability
- Launching after setupLaunches for a practice after its setup steps.
- Part of the cycle
- Recover: denials, appeals and ar follow-up
- What it costs
- Included in the full service at 1.5% of insurance collections, meaning payments received from payers. Patient payments are not included.
- Your practice
- Review, sign and file where the payer requires it. For Medicare, that is on the MAC portal or by mail.
Who does what
Eligibility Hub does
- Classify each denial from its reason codes
- Choose the remedy, with the reason: reopening, corrected claim, redetermination, reconsideration or write-off
- Build the evidence packet from the chart (measurements, standard-of-care history, application notes, photos) and draft the appeal letter
- Alert you before statutory deadlines lapse
- Record outcomes and escalate to the next level
Your practice does
- Review, sign and file where the payer requires it. For Medicare, that is on the MAC portal or by mail.
How denials are sorted and timed
Denial categories
- Clerical
- Medical necessity
- Frequency
- Bundling
- Coverage
- Timely filing
- Duplicate
Medicare deadlines we track
- Redetermination: 120 days
- Reconsideration: 180 days
- Reopening: one year
Limits worth knowing
- Payers decide outcomes. We prepare the strongest case the documentation supports.
- We do not provide legal advice.
Questions
Which denials do you work?
Every denied or short-paid line, classified from its reason codes and worked to a decision.
Who files the appeal?
Where the payer requires it, your authorized person signs and files, for Medicare on the MAC portal or by mail. We prepare everything and track it to decision.
Do you work denials left by our previous biller?
Yes. When service goes live, open denials from the prior biller are worked to decision.
Can you guarantee an appeal will succeed?
No. Payers decide. We track statutory deadlines so no appeal is lost to a missed date.
Review the scope before you begin
The full service is 1.5% of insurance collections, meaning payments received from payers. Patient payments are not included. See pricing for how the fee is calculated.
Last updated 2026-10-06