Denials Management

Contest medical necessity and clinical validation (DRG) denials.

Why Brundage Group

Payor denials are increasing at an alarming rate and hospitals must be proactive in securing denials management support. Our organization has extensive subject matter expertise in denial resolution to ensure accurate reimbursement.

When claims are denied, timing is critical to determine whether there is merit for an appeal. With a focus on effective overturn rate, our physician advisors help hospitals quickly and effectively determine which cases to review, when to review the cases, and when to appeal.

Peer-to-Peer Support

Our experienced physician advisors have completed thousands of peer-to-peer cases, gaining insight into payor tactics. We utilize this expertise to effectively and compliantly secure your earned revenue.

Appeals Support

Our physician advisors have extensive medical necessity and clinical validation denials experience and formulate appeal letters using evidence-based medical literature. We support all levels of appeal, including negotiations with an Administrative Law Judge (ALJ) or Independent Review Organization (IRO).

Contract Consultation

Reviewing and understanding key contract clauses is essential to mitigate payor tactics. Through significant client engagements and decades of experience, our team can identify common contracting pitfalls that are frequently missed. Our executive physician advisors have extensive contracting experience and are available to discuss key contracting strategies.

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