Medicare Claims Issues? | Get Expert Help with Denials, Appeals & Billing Problems
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.

Common Denial Reasons:
  • 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.

Appeal Levels:
  • 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.

Common Billing Issues:
  • 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.

Provider Issues:
  • 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.

Drug Claim Issues:
  • 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.

Documentation Problems:
  • 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.

1
Initial Review
Comprehensive review of your claim, denial, and documentation
2
Investigation
Detailed investigation with providers and Medicare
3
Documentation
We gather all supporting records and evidence
4
Advocacy
Direct advocacy with insurers and providers
5
Appeals
We file formal appeals with complete evidence
6
Resolution
We ensure proper payment and final resolution
Time Sensitive: Medicare appeals have strict deadlines. Contact us immediately if you receive a denial notice so we can meet all required timeframes.

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

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