Top 15 Denial Management Companies in USA

Healthcare providers in the USA lose billions each year due to denied claims. Denial management companies help practices and hospitals recover lost revenue. This can be done by identifying the root causes of denials, addressing claim corrections, and implementing proactive solutions. These companies like MedBrilliance also offer coding audits, payer follow-up, and AI-driven analytics to reduce repeat denials.

Overview of 15 Denial Management Companies – Their Specialties and Features

Here is an overview of the major companies that are best for dealing with the denial management claims:

Detailed Information Regarding the Top 15 Denial Management Companies

MedBrilliance brings the basic introduction, location, services, and the pros and cons of these denial management companies:

1. R1 RCM

Introduction: R1 RCM is one of the largest revenue cycle management companies in the USA. It supports hospitals, health systems, and physician practices with denial prevention strategies. The company is known for using advanced analytics to cut claim rejection rates.

Operating Location: Headquartered in Chicago, Illinois, serving providers nationwide.

Services:

• Denial management with predictive analytics.
• Prior authorization support for faster approvals.
• Accounts receivable recovery with dedicated teams.
• Root cause analysis of denials to prevent recurrence.
• Automation-driven claim resubmission processes.

R1 RCM’s services are designed for large hospitals that need both denial prevention and recovery. Its AI-based solutions reduce recurring denials and improve overall revenue cycle efficiency.

Pros and Cons:

2. Omega Healthcare

Introduction: Omega Healthcare delivers outsourcing and analytics solutions with a strong focus on denial management. The company works with hospitals, physician groups, and payers. It is trusted for handling high-volume claims efficiently.

Operating Location: Based in Boca Raton, Florida, with global delivery centers.

Services:

• Denial analytics and prevention strategies.
• Comprehensive coding audits to minimize rejections.
• Payer follow-up and appeals management.
• Revenue leakage identification with data insights.
• End-to-end revenue cycle outsourcing.

Omega Healthcare combines skilled workforce capacity with technology-driven insights. This makes it a reliable option for organizations that handle thousands of claims daily and need both speed and accuracy.

Pros and Cons:

3. GeBBS Healthcare Solutions

Introduction: GeBBS Healthcare Solutions specializes in denial management and coding services. It serves hospitals and mid-sized providers, combining technology with domain expertise. Their AI tools help track denial patterns in real time.

Operating Location: Culver City, California.

Services:

• Denial management with workflow automation.
• Comprehensive coding and compliance audits.
• Intelligent AR recovery tools.
• Real-time denial analytics dashboard.
• HIPAA-compliant revenue cycle outsourcing.

GeBBS integrates advanced reporting with hands-on support, giving providers real visibility into denial causes. Its automation tools save time and reduce administrative burden for billing departments.

Pros and Cons:

4. Change Healthcare

Introduction: Change Healthcare offers technology-driven solutions for denial prevention and revenue performance improvement. It is widely used by large hospitals and integrated health systems. Its AI-backed tools correct claims before submission.

Operating Location: Nashville, Tennessee.

Services:

• Denial prediction with AI.
• Claim corrections before submission.
• Accounts receivable management.
• Data-driven revenue cycle performance tools.
• Appeal and resubmission management.

Change Healthcare’s solutions help identify errors before claims reach payers. This not only improves first-pass acceptance rates but also prevents backlogs in accounts receivable.

Pros and Cons:

5. Access Healthcare

Introduction: Access Healthcare is a global RCM company serving U.S. providers. It offers scalable denial management teams with strong focus on accuracy. The company uses automation to reduce claim rejections.

Operating Location: Dallas, Texas, with global offices.

Services:

• Denial management with workflow optimization.
• Payer follow-ups and appeals resolution.
• Accounts receivable recovery teams.
• Intelligent denial tracking dashboard.
• Customized outsourcing solutions.

Access Healthcare focuses on delivering measurable outcomes for revenue recovery. It supports large-scale healthcare networks needing denial prevention at scale.

Pros and Cons:

6. Vee Technologies

Introduction: Vee Technologies provides denial management, billing, and coding services for U.S. healthcare providers. It serves hospitals, practices, and healthcare systems with customized outsourcing solutions. The company is valued for its compliance and reliability.

Operating Location: New York, NY, with global delivery centers.

Services:

• Denial tracking and reporting in real time.
• AR recovery with dedicated staff.
• Medical coding and compliance checks.
• Payer appeal management.
• Custom denial prevention strategies.

Vee Technologies make sure that denials are tracked around the clock, reducing payment delays. Its teams combine technology with compliance checks, making it a trusted partner for providers.

Pros and Cons:

7. Sunknowledge Services Inc.

Introduction: Sunknowledge is a U.S. based denial management and billing company specializing in DME and HME providers. It also serves clinics and practices with full cycle billing solutions. Its affordable pricing makes it a strong choice for smaller providers.

Operating Location: New York, NY.

Services:

• Denial management with appeal handling.
• Prior authorization services.
• Durable medical equipment billing support.
• Payer follow-up and AR recovery.
• Telehealth billing and compliance services.

Sunknowledge emphasizes transparent operations and cost-effectiveness. It helps providers manage both pre-authorization and denial resolution, reducing revenue leakage significantly.

Pros and Cons:

8. MedBrilliance

Introduction: MedBrilliance provides customized and affordable medical billing and RCM services along with minimal denial rate. The company assists the clinicians and other health care providers in cardiology, psychiatry, chiropractic, pediatrics and other specialization fields.

Operating Location: Austin, Texas, USA

Services:

• Eligibility & benefits checks.
• Accurate ICD-10/CPT coding by AAPC-certified coders.
• Clean claim submission and real-time scrubbing.
• Denial management, appeals, and A/R follow-up.
• Transparent reporting and month-end reconciliation.

Pros and Cons:

9. Coronis Health

Introduction: Coronis Health offers specialty-focused denial management and billing solutions. It combines local U.S.-based support with offshore resources for flexibility. The company adapts workflows for practices in diverse specialties like radiology, anesthesia, and surgery.

Operating Location: Annapolis, Maryland.

Services:

• Denial management specific to their expertise.
• Coding audits and compliance reporting.
• Payer appeal submission and tracking.
• Full-cycle medical billing solutions.
• Real-time financial analytics.

Coronis Health’s specialty approach makes it stand out. Providers receive solutions aligned with their practice needs, ensuring more efficient claim recovery.

Pros and Cons:

10. iRCM Inc.

Introduction: iRCM Inc. is a U.S.-based billing and denial resolution company. It focuses on making denial management simple for clinics with real-time dashboards. The company delivers cost-effective services to optimize revenue cycles.

Operating Location: New York, NY.

Services:

• Denial resolution dashboards for providers.
• Claim corrections and appeals.
• Medical billing and AR management.
• Real-time denial analytics reports.
• Compliance-based coding reviews.

iRCM stands out for its easy-to-use dashboard solutions. Practices can track denial causes instantly and make corrections faster without complex systems.

Pros and Cons:

11. Promantra

Introduction: Promantra provides medical billing and denial management outsourcing with a focus on small to mid-sized providers. It ensures HIPAA compliance and personalized support for U.S. practices. The company has built a reputation for reliability.

Operating Location: Somerset, New Jersey.

Services:

• Denial management with payer follow-ups
• End-to-end medical billing support
• Claims correction and appeals filing
• AR management solutions
• Coding audits for error reduction

Promantra emphasizes personalized client service. Its denial management model helps smaller practices maintain financial stability through faster collections.

Pros and Cons:

12. eClinicalWorks

Introduction: eClinicalWorks is an integrated practice management and EHR platform. It offers built-in denial handling features to optimize billing. Many small and mid-sized practices in the USA use its tools.

Operating Location: Westborough, Massachusetts.

Services:

• Integrated denial workflows in software.
• Medical billing and AR recovery.
• Claims submission and correction tools.
• Practice management with EHR integration.
• Denial analytics reporting.

eClinicalWorks guarantees that providers manage denials within the same system they use for clinical records. This saves time and minimizes errors between clinical and financial workflows.

Pros and Cons:

13. AdvantEdge Healthcare Solutions

Introduction: AdvantEdge provides denial management and revenue cycle solutions to U.S. practices, clinics, and hospitals. It integrates business intelligence to help providers understand denial patterns.

Operating Location: Lombard, Illinois.

Services:

• Denial prevention and appeals support.
• Business intelligence-driven analytics.
• Specialty-specific billing solutions.
• AR management and collections.
• Compliance-driven coding services.

AdvantEdge combines data insights with specialized billing workflows. This makes it a strong option for providers seeking both compliance and efficiency.

Pros and Cons:

14. CareCloud

Introduction: CareCloud delivers cloud-based billing, RCM, and denial management services. It focuses on predictive denial analytics and user-friendly platforms. The company helps providers scale without infrastructure limitations.

Operating Location: Somerset, New Jersey.

Services:

• Predictive denial analytics platform.
• AR recovery and appeals support.
• Medical billing and claim corrections.
• Real-time denial trend dashboards.
• Cloud-based practice management.

CareCloud makes denial management accessible to providers through cloud technology. Its platform reduces IT costs while providing advanced denial tracking.

Pros and Cons:

15. Athenahealth

Introduction: athenahealth offers cloud-based denial management and EHR services. It is widely adopted in U.S. practices and clinics for automated claim resolution. The company focuses on reducing billing backlogs.

Operating Location: Watertown, Massachusetts.

Services:

• Automated denial tracking system.
• Claim resubmission workflows.
• AR management and collections.
• Billing and compliance services.
• Cloud-based EHR with RCM solutions.

Athenahealth automates repetitive denial tasks, improving efficiency for practices. Its cloud system helps providers track financial and clinical data in one place.

Pros and Cons:

Why Choose Medbrilliance?

MedBrilliance provides premium services based on the requirements of the hospital and the health care providers. We provide the denial management and provide the top quality services to overcome denials to the claims. Choosing MedBrilliance is the best decision to take for outsourcing your medical billing services and reducing claim denials.

Check out MedBrilliance RCM LLC latest research on Top 15 Medical Coding Companies in the World.

FAQs

1. What does a denial management company do?

A denial management company reviews denied insurance claims, finds the cause, and resubmits them to help doctors recover lost revenue.

2. Why should doctors in the USA use denial management services?

Doctors use denial management to reduce claim denials, improve cash flow, and save time on complex insurance processes.

3. How to choose the best denial management company in the USA?

Check experience, success rate in overturning denials, industry certifications, pricing, and integration with your billing system.

4. Do denial management companies also handle medical billing?

Yes, most denial management companies in the USA also provide full medical billing, coding, and revenue cycle management services.

We strictly follow all standard medical billing protocols and you can learn more about medical billing services through Wikipedia.