Definition of Denial and Appeal Management

Healthcare denial and appeal management is the cumulative work completed by administrative, clinical, coding, and revenue cycle professionals with specialized training in the field. These professionals process denials, underpayments, and overpayments issued by medical insurance agencies and file appeals for inappropriate denials. The goal of healthcare denial and appeal management is to prevent inappropriate denials from occurring through informing and assisting front-end revenue cycle administrative, clinical, and coding processes.