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ERN

The Key to Unlocking Your Full Revenue Potential

Denials are not just an inconvenience—they are a billion-dollar problem for healthcare providers. Whether caused by medical necessity disputes, technical errors, or delayed appeals, each denied claim represents lost revenue and wasted resources. At ERN, we help healthcare organizations prevent, manage, and overturn denials through proactive strategies, ensuring faster reimbursements and financial stability.

Why a Proven Denial Strategy Can Save You Millions

$19.7B

spent trying to overturn denied claims in 2022.

85%

of claims denials are recoverable.

67%

of claim denials are recoverable.

41%

of appealed denials are reversed in favor of the provider.
Without a proven denial strategy, providers risk millions in unnecessary write-offs. ERN ensures your organization is equipped to prevent and recover denials before revenue is lost.

Prevent Denials, Maximize Revenue

With years of experience in healthcare reimbursement advocacy, ERN offers a comprehensive approach that combines administrative expertise, technology, and proven strategies to reduce denials and recover revenue. We’re dedicated to partnering with you to ensure that your claims are processed smoothly and efficiently from the start.
Payers often deny claims based on medical necessity, even when treatment was essential, forcing providers to undergo complex appeals to justify care. These denials can stall reimbursements and burden providers with unnecessary administrative work. ERN leverages administrative laws and medical necessity protections to dispute wrongful denials, ensuring claims are reviewed by qualified medical professionals and not arbitrarily rejected.
Incorrect coding, missing documentation, or payer-imposed technicalities can result in immediate denials, even when care was properly provided. Without a structured response, these denials can lead to lost revenue and excessive rework. ERN strengthens claim submissions with compliance-driven audits, proactive tracking, and payer-specific strategies to prevent technical denials before they happen.
As denied claims age past payer deadlines, the chance of successful recovery decreases significantly. Lack of proper follow-up, payer delays, and slow responses often cause providers to write off legitimate revenue. ERN ensures persistent follow-ups, regulatory escalations, and expert appeals to recover aged denials before they result in permanent losses.
Payers frequently downcode or dispute Diagnosis-Related Group (DRG) classifications, reducing payments for high-cost inpatient stays. These denials lead to underpayments that can significantly impact hospital financials. Alongside your CDI department, ERN aggressively challenges DRG downgrades, enforces correct payment structures, and prevents revenue loss due to improper payer adjustments.

End-to-End Denial Prevention & Resolution

ERN’s Denials Prevention & Management services offer a comprehensive approach to addressing and preventing claim denials. By leveraging our expertise in healthcare regulations and claims management, we proactively address the root causes of denials, reduce administrative burdens, and improve your revenue cycle.

RevAssurance

TRAF Representation

NCRA Certified Training

ClaimCure Consulting

Speak to a Denial Expert Today

Schedule a consultation with ERN today to learn how our comprehensive denial management solutions can streamline your revenue cycle, reduce future denials, and maximize your reimbursement.