Three Ways We Secure Your Revenue
Reverse Denials
Leverage clinical coding expertise to turn rejected claims into consistent, successful reimbursements.
Maximize Yield
Target high-value recovery opportunities that often slip through the cracks of standard automated systems.
Total Visibility
Eliminate guesswork with real-time tracking that shows exactly where revenue is leaking and how it’s being recovered.
Reliable Recovery for a Healthier Revenue Cycle
It is hard to keep up with insurance rejections when your main focus is on patient care. LexiCode’s Edits & Denials Services fill that gap by providing certified experts who bring deep coding knowledge to your revenue cycle. We handle the forensic research and clinical validation required to resolve complex claims, ensuring you never leave earned revenue behind.
This recovery process also provides the data needed to prevent denials entirely. Our denial management solutions give you the clarity to see exactly what is triggering rejections, allowing you to adjust documentation and coding workflows in real-time. By addressing these root causes, we ensure higher first-pass accuracy, lowering your overall denial rate and keeping your financial foundation solid over the long term.
The LexiCode Resolution Method
Our process is designed to find every missing dollar and stop rejections before they happen.
- Analyze the Data
We start by using AI-enhanced analytics to look at your data and find exactly where and why claims are failing. By seeing these trends clearly, we know exactly what to fix first. - Audit for Quality
Our credentialed coders (RHIA, RHIT, CCS, CPC) double-check your coding and documentation against current payer rules. This step ensures that your claims are accurate the first time they go out. - Execute the Appeal
When a denial happens, our experts handle the heavy research and the formal appeal process. Because our team undergoes continuous education, they are uniquely equipped to navigate even the most complex payer requirements. - Sustain Your Success
We help you update your internal workflows using predictive analytics based on what we learn. This constant improvement lowers your future denial rate and protects your revenue for good.
Get In Touch
Stop the Cycle of Rejections
Payer requirements are too volatile for legacy software to handle alone. Outsource your most challenging rejections to LexiCode and put a dedicated team of AHIMA-certified coders to work defending your clinical documentation and securing the reimbursement you’ve earned.
Related Capabilities
View additional LexiCode services designed to support coding, documentation, and audit-driven quality across the revenue lifecycle.
View all
Medical Coding Services
Accurate, compliant medical coding supporting clean claims and timely reimbursement.
Medical Coding Audit Services
Providing independent insight into coding quality, compliance risk, and revenue impact.
Risk Adjustment Services
Delivering RAF confidence through precise documentation, coding validation, and insight.
Edits and Denials Services
Bringing structure and follow-through to denied claims that stall reimbursement.
Clinical Documentation Improvement (CDI) Services
Strengthening clinical documentation to accurately reflect patient complexity and care delivered.
FAQS
Frequently Asked Questions
Why is clinical coding expertise necessary for effective Edits & Denials Services?
Complex rejections are often triggered by documentation gaps or errors in coding. While your legacy software flags basic technical issues, it cannot perform the clinical validation required for deep-level records. Our experts perform a forensic review of your charts to ensure codes reflect the true level of care.
How do your experts stay current with changing payer rules?
We provide ongoing virtual education and coder activity monitoring to keep our team ahead of regulatory shifts. This is managed through the LexiCode Audit Database (LAD), which provides the volume and audit tools necessary for precise analysis, modeling, and flexible training programs tailored to your organization’s needs.
Does LexiCode use technology to support the process?
Our Autonomous Coding Platform (part of the XBP Global portfolio) utilizes an AI-powered workflow to transition manual processes into autonomous ones. This reduces overall coding costs and enhances accuracy by utilizing a systematic approach to validate results.
How does LexiCode handle complex challenges like DRG shifts?
Our credentialed consultants are trained to defend the clinical documentation behind DRG assignments and outpatient APCs. We focus on denial management solutions rooted in clinical fact to recover revenue that automated systems often overlook.
How can we track the impact of our partnership?
Through our BEATS platform, you get a clear view of your performance metrics. You can see real-time data on recovered revenue and monitor how interventions from our team are improving your overall accuracy and lowering your rejection rate over time.
Our Award-Winning Expertise
Explore our gallery of awards and milestones that recognize our contributions to improving healthcare quality and performance.
NelsonHall
NelsonHall’s Healthcare Payer Operational Transformation NEAT Vendor Evaluation 2023
Everest Peak Matrix
PEAK Matrix® for Medical Coding Operations 2022
Everest Peak Matrix
PEAK Matrix® for Intelligent Automation Healthcare 2022
