Denial Management & Appeals
Strategic, medically backed appeals that turn IONM denials into recoveries.
Every Denial Has a Fight Plan
At APEX IONM, we don’t treat claim denials as final—we treat them as challenges to overcome. Our denial management and appeals process are engineered for intraoperative neuromonitoring (IONM) complexity, using customized, evidence-based tactics to overturn denials and recover lost revenue.
No templates. No shortcuts. Just expert-driven appeals that work.
Why This Step Matters
- ~12% of IONM claims are denied on first pass—most are avoidable or reversible with the right strategy.
- Many generic RCM firms give up after the first denial or send vague template appeals that rarely succeed.
- Denied claims can still be high-value recoveries if handled quickly and strategically.
What We Do
✅ Root Cause Analysis
We evaluate every denial to determine whether it's due to coding, documentation, payer error, or lack of medical necessity.
✅ Bespoke Appeal Letters
No one-size-fits-all templates here. Each appeal is crafted with supporting documentation, clinical rationale, and legal/policy references.
✅ Cross-Trained Appeal Teams
Our appeal specialists are trained by technologists—ensuring that clinical indications and nuances of IONM are correctly represented.
✅ Policy-Backed Arguments
We leverage CMS, payer manuals, and federal laws (including the No Surprises Act) to strengthen our appeals.
✅ Escalation Protocols
When standard appeals are denied, we escalate to arbitration, state departments, or regulatory agencies as needed.
What Sets APEX Apart
Strategic Depth
We don’t appeal just to appeal. We design each challenge based on the best path to resolution—maximizing ROI per claim.
Clinical Accuracy
Our tech-informed appeal writers ensure that every argument is medically sound and payer-specific.
Escalation Experts
We routinely escalate complaints to departments of insurance, CMS, and DOL—holding payers accountable for bad behavior.
Results-Focused Approach
We track success rates by payer and denial type, refining our strategies continuously to improve overturn outcomes.
Result: More Wins. Fewer Write-Offs.
Denied claims don’t scare us. In fact, they’re often our biggest opportunity to prove value. With APEX, your appeals are handled like high-stakes negotiations—because they are.
Ready to Transform Your Revenue Cycle?