Recover up to 85% of denied claims. Priman's expert denials and appeals team maximizes your revenue using precise, payer-specific appeals strategies and root-cause analysis that prevents the same denials from recurring.
With 65% of denied claims being overturnable, practices lose an average of $43,000 every year simply by abandoning the appeals process. A denial in healthcare billing is not a final verdict — it is often just the beginning of a conversation. Yet every day these claims sit unappealed, your practice loses earned revenue.
Priman's proactive denials and appeals management ensures you recover every dollar you have rightfully earned — with a track record of 80–85% appeal success rates across all major payers.
Our payer-specific appeal strategies and clinical documentation expertise turn denials into payments.
We immediately review the denial reason — coding discrepancy, medical necessity, timely filing, or missing documentation — and determine the right appeal pathway.
Our specialists gather all necessary supporting materials: clinical records, operative reports, and payer-specific guidelines to build a compelling case.
We draft custom, persuasive appeals tailored to each payer's unique requirements and adjudication criteria — not generic template responses.
We monitor all filing limits and appeal deadlines, submit every appeal on time, and track status through to final adjudication.
| Metric | Before Priman | After Priman | Improvement |
|---|---|---|---|
| Appeal Success Rate | 35–45% | 80–85% | +40% |
| Average Days to File Appeal | 10–15 days | 3–5 days | 65–75% Faster |
| Repeat Denial Rate | 18% | <5% | 72% Reduction |
| Appeal Backlog | 200+ claims | <50 claims | 75% Decrease |
| Documentation Compliance | 80% | 99% | +19% Improvement |
We maintain a comprehensive library of appeal templates and deep knowledge of guidelines for every major payer — Medicare, Medicaid, and all commercial insurers.
Every appeal is supported with clinical documentation, medical necessity justification, and coding rationale — not just form letters.
We analyze denial patterns and root causes, then share those insights with your team to prevent the same denials from recurring month after month.
From Level I to complex Level II appeals, we manage the entire appeals lifecycle and escalate to external review when warranted.
Our dedicated denial specialists are critical thinkers who understand the nuances of each claim — providing a strategic advantage no automation tool can match.
Every denied claim is a recovery opportunity. Let Priman's appeals specialists fight for every dollar your practice has earned.
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