Expert Medical Billing

Appeal Specialist Services

Win Denied Claims • Recover Lost Revenue • Strengthen Cash Flow

Denied claims don’t have to mean lost income.
Our Appeal Specialist Services help healthcare providers identify, correct, and successfully appeal denied claims — turning rejected payments into recovered revenue.

HIPAA-Compliant | 95 % Successful Appeal Rate | Trusted Nationwide
Based in Orlando, FL & Roanoke, VA — Serving Healthcare Providers Across the U.S.

Why Appeals Matter in Medical Billing

Claim denials are inevitable — but losing money to them isn’t.
Whether caused by coding errors, missing documentation, eligibility issues, or payer misinterpretation, each denied claim represents earned revenue left on the table.

At Expert Medical Billing Services, our trained appeal specialists work relentlessly to analyze, correct, and overturn denials with payer-specific expertise.
We manage the entire process — from denial analysis to documentation and re-submission — ensuring your practice gets paid fully and fairly.

Our Denial Appeal Process

1️⃣ Denial Identification

We extract denial data from EOBs, ERAs, and payer portals to determine the cause — whether clinical, technical, or administrative.

2️⃣ Root Cause Analysis

Our certified coders and billing experts review each denial, matching payer rules and medical necessity guidelines to identify what went wrong.

3️⃣ Appeal Documentation Preparation

We compile all required materials — medical records, clinical notes, authorization proofs, and reference letters — for a strong appeal submission.

4️⃣ Appeal Submission & Payer Communication

Appeals are filed through electronic, fax, or payer-specific portals within 24–48 hours.
Our team maintains direct communication with payers to track appeal progress and secure resolution.

5️⃣ Outcome Tracking & Prevention

Once resolved, we record outcomes, identify recurring denial patterns, and provide detailed insights to help prevent future rejections.

Common Denials We Appeal

Our appeal specialists handle every type of denial — from simple clerical errors to complex medical necessity disputes.

Here are the most frequent denial categories we overturn:

  • Eligibility or coverage errors

  • Missing or incorrect CPT/ICD-10 codes

  • Authorization and pre-certification denials

  • Medical necessity rejections

  • Timely filing denials

  • Bundling/unbundling disputes

  • Duplicate or overlapping claim rejections

  • Underpayment or payment variance issues

We also manage second-level and third-level appeals, ensuring no claim is left unresolved or written off prematurely.

Why Choose Expert Medical Billing Services?

AdvantageWhat It Means for You
95 % Appeal Success RateWe win back most denied or underpaid claims
Certified Appeal SpecialistsExperienced with multi-payer and multi-specialty appeals
Faster TurnaroundResubmissions completed within 24–48 hours
Root Cause AnalyticsDetailed reporting to prevent repeat denials
Nationwide CoverageOffices in Florida & Virginia, serving providers across all 50 states
Full HIPAA CompliancePatient data and payer communication securely managed

Our appeal team acts as your dedicated revenue recovery partner, ensuring denied claims are handled with strategy, speed, and precision.

Our Appeal Specialist Service Includes

      • Detailed denial identification and categorization
      • Appeal documentation preparation (clinical & administrative)

      • Payer-specific appeal submissions

      • First-level, second-level, and third-level appeal handling

      • Direct follow-ups with insurance representatives

      • Re-submission of corrected claims

      • Tracking of appeal status and turnaround time

      • Underpayment analysis and payer variance recovery

      • Root cause and trend reporting

      • Staff feedback and training recommendations

Industries & Specialties We Support

Family Medicine | Internal Medicine | Orthopedics | Cardiology | Dermatology | OB/GYN | Pediatrics | Behavioral Health | Dentistry | Radiology | Multi-Specialty Clinics

Whether you’re a specialist practice in Orlando, a hospital department in Roanoke, or a multi-location healthcare group, our appeal experts ensure no valid claim remains unpaid.

Proven Results for Our Clients

📈 95 % Appeal Success Rate
💰 30 % Increase in Monthly Collections after 90 days
40 % Faster Claim Resolution through automation + manual follow-up
💬 “They turned our backlog of denied claims into collected payments within weeks.” — Dr. H. Morgan, Florida
💬 “The appeal process was seamless — our recovery rate has never been higher.” — Dr. J. Nguyen, Virginia

Contact Us

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Frequently Ask Questions

Almost all — including eligibility, authorization, coding, medical necessity, and timely filing denials. Each appeal is customized to payer rules.

Most appeals are submitted within 48 hours, and resolutions typically occur within 30–45 days, depending on payer timelines.

Yes. We analyze EOBs, identify payer underpayments, and submit appeals for payment variance recovery.

 

Absolutely. We provide detailed denial reports, appeal success metrics, and payer-specific insights monthly.

 

No. While our main offices are located in Orlando, FL and Roanoke, VA, we serve providers nationwide through secure, HIPAA-compliant systems.

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