Clinical Denials. Appeals. Utilzation Management.
Services
Inpatient Medical Necessity and Readmission Appeals
Outpatient Medical Necessity and No Authorization Appeals
Outpatient Medical Necessity and No Authorization Appeals
Appealing inpatient medical necessity denials is cumbersome and time-consuming. Let Apricity's experienced appeal nurses overturn these for you.
Outpatient Medical Necessity and No Authorization Appeals
Outpatient Medical Necessity and No Authorization Appeals
Outpatient Medical Necessity and No Authorization Appeals
Denials for no authorization, changed CPT code, and medical necessity can be costly and take a lot of time for your denials team. Let our expert RNs appeal these on your behalf.
Utilization Review Consulting
Outpatient Medical Necessity and No Authorization Appeals
Utilization Review Outsourcing
Your utilization management team is the backbone of your inpatient revenue. If you are experiencing a high observation rate or your UM team would benefit from training, our team can help.
Utilization Review Outsourcing
Provider Documentation Consulting
Utilization Review Outsourcing
We understand that finding Utilization Review nurses can be a challenge, especially in rural areas. Our team of RNs can provide expert level support to your organization.
Provider Documentation Consulting
Provider Documentation Consulting
Provider Documentation Consulting
Is your provider documentation contributing to payer downgrades, denials, and recoupments? We offer targeted training for your providers to ensure their documentation accurately reflects the patient's complexity and severity of illness.
Medicare Advantage Appeal Support
Provider Documentation Consulting
Provider Documentation Consulting
Medicare Advantage payers are denying both inpatient and outpatient cases at a much higher rate than other payers. Our experts will work to overturn your Medicare Advantage denials.
Payer Audits
Payer Audits
Payer Audits
Whether it's a government audit, such as a RAC, CERT, PERM, TP&E, or a specific payer audit, our team can help ensure you have everything for the pull list and with the appeals.
Dedicated. Personalized. Professional.
Why Choose Us?
At Apricity, we know clinical denials. You never have to worry that we will outsource your claims or they will be worked by someone with little to no healthcare background. The Apricity team member who is working on your appeal is a licensed RN with several years of experience working in hospitals. While we understand the complexity of the healthcare insurance appeals processes, we take the most pride in understanding the reason why that care was needed and the complex patient condition that required the services. Our years of nursing experience gives us a distinct advantage in verbalizing the reasons why services were required at the level they were given. This has led to hundreds of millions of dollars of recovered revenue for our clients. Your dedicated staff provided the care; let us help you get paid for it.
About Apricity Healthcare Solutions
Our Mission
Our Services
Our Mission
Apricity Healthcare Solutions, LLC’s mission is to assist healthcare institutions in retaining and recouping the payments owed to them while using data and metrics to guide denials prevention activities within the institution.
Our Team
Our Services
Our Mission
Our team succeeds when your team succeeds. We are committed to working with your provider, utilization management, billing, patient access, and leadership teams to help your organization develop processes that prevent clinical denials and make denials that do exist easier to overturn.
Our Services
Our Services
Our Services
We are laser-focused on overturning denials, strengthening your utilization management team, and getting you paid for the care you give. See our services page for more details.
