95%
Success Rate
1000+
Claims Resolved
18+
Years Experience
24/7
Support Available
Medicare Claims Issues We Resolve
Our experienced team handles all types of Medicare claims problems, from simple billing errors to complex appeals processes. No issue is too complicated.
Claim Denials
We analyze denial reasons, gather supporting documentation, and work with providers to resolve issues or file successful appeals.
- Medical necessity questions
- Incorrect coding or billing
- Missing prior authorization
- Provider network issues
Appeals Process
Navigate appeals with expert guidance. We handle all levels—from redeterminations to ALJ hearings.
- Level 1: Redetermination
- Level 2: Reconsideration
- Level 3: ALJ Hearing
- Level 4: Medicare Appeals Council
Billing Errors
We review Medicare Summary Notices and work with providers to correct duplicate charges, coding issues, and other billing mistakes.
- Duplicate charges
- Incorrect procedure codes
- Wrong insurance information
- Coordination of benefits errors
Provider Disputes
When providers and Medicare disagree on coverage or payment, we advocate for you and resolve disputes fast.
- UT Medical Center billing
- Covenant Health disputes
- Specialist referral problems
- Emergency room claims
Prescription Drug Claims
We help with formulary exceptions, prior authorizations, and coverage determinations for your medications.
- Formulary restrictions
- Prior authorization denials
- Step therapy requirements
- Quantity limit exceptions
Medical Records Issues
We coordinate with providers to ensure complete documentation and timely submission of required records.
- Missing medical records
- Incomplete documentation
- Provider communication gaps
- EHR system issues
Our Claims Assistance Process
Our systematic approach ensures thorough investigation and resolution of your Medicare claims issues.
Step 1
Initial Review
Comprehensive review of your claim, denial, and documentation.
Step 2
Investigation
Detailed investigation with providers and Medicare.
Step 3
Documentation
We gather all supporting records and evidence.
Step 4
Advocacy
Direct advocacy with insurers and providers.
Step 5
Appeals
We file formal appeals with complete evidence.
Why Choose Our Claims Assistance
Our experience with Medicare claims and close relationships with local providers give us unique advantages in resolving your issues.
Expert Knowledge
18+ years navigating Medicare claims, appeals, and billing regulations effectively.
Local Relationships
UT Medical Center, Covenant Health, and local specialists—connections that speed resolution.
Personal Advocacy
Beyond paperwork—we actively fight for your rights and benefits.
Timely Response
We prioritize time-sensitive appeals and redeterminations to protect you.
Thorough Documentation
Complete records and copies of all correspondence for your files.
Ongoing Support
From first review to final resolution, we stay with you every step.
Don’t Fight Medicare Claims Issues Alone
Medicare claims can be overwhelming. Let Knoxville’s specialists fight for your rights and get the results you deserve.
- Free initial claims review and consultation
- Expert advocacy with Medicare and providers
- Complete appeals process management
- No upfront fees — we work on your behalf
Available Monday–Friday 9AM–5PM · Emergency claims assistance available