Services
Denial management services, three ways in.
Audit, prevention and recovery for commercial behavioral health claims. Most clients start with the audit.
Denial audit
Fixed fee from $1,250
A short, fixed-fee report built from your own remits and aging. It starts de-identified, so no patient data is needed.
- Denials by payer, reason code and age
- The dollar value of denials still inside their appeal window
- Hours your team spends on denial work today
Denial prevention
Fixed-price projects, scoped in writing
We build automation inside the systems you already use, so fewer claims deny in the first place. Official connections only.
- Eligibility and benefits checks on a schedule, not only at admission
- Authorization status checked against each claim before it goes out
- Claim-status follow-up through your clearinghouse
Denial recovery
You pay only on dollars recovered
We work the commercial denials your team does not have time for: medical necessity, level of care, authorization and aged A/R follow-up.
- Every in-scope claim worked, with a reason when we skip one
- Appeals drafted from the chart and approved by a specialist
- External review support when the case warrants it, with the member's authorization
Reporting
Measured in dollars.
Every engagement reports dollars recovered, decisions by payer and days to payment. Not sure which service fits? See how the options compare.
What we commit to
- Report in 10 business daysYour denial review report within 10 business days of receiving a de-identified export.
- Specialist approvalEvery appeal is approved by a specialist before it is sent.
- Logged and reportedEvery action is logged. You get a report every week.
- BAA before PHINo patient data until a BAA is signed, plus a Part 2 agreement for SUD records.
Commitments about how we work, not promises about payer decisions.
Next step
Book a denial review.
Twenty minutes. No patient data needed.
Or email hello@skygathering.com