Infusion Insurance Appeals
Payer-specific appeal support for denied infusion claims.
Build an Appeal That Answers the Payer’s Reason for Denial
When an infusion claim is denied, the records that could support an appeal may be spread across your billing system, the treating provider’s office, and the team that administered the infusion. Your billing team has to pull those records together, determine what addresses the denial, and prepare a response while keeping up with current claims.
Mixon Revenue Solutions works alongside your billing team to prepare and follow up on eligible infusion insurance appeals. We review the payer’s explanation, identify the records that support your case, and connect those records to the specific reason payment was denied.
How We Prepare and Follow Up on Infusion Claim Appeals
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Review the Denial and Appeal History
We review the denial notice, available claim records, and any previous submissions or payer responses. That helps us identify what the appeal needs to address, which deadlines apply, and whether another level of review is available.
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Gather the Records That Support the Appeal
We help your team identify and collect the documentation relevant to the denial. Depending on the claim, that may include prior authorization records, treatment orders, clinical notes, or infusion administration records. If a letter of medical necessity is needed, we coordinate with the treating provider for the clinical details that support it.
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Prepare a Payer-Specific Appeal
We prepare an appeal that addresses the payer’s stated reason for denial, include the records that support it, and submit it to the payer on your behalf. For an authorization discrepancy, that may mean showing how the approved medication and dates of service match the treatment record and claim.
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Follow Up After Submission
After we submit the appeal, we track its status, coordinate responses to requests for additional information, and review the payer’s decision with your team. If the payer upholds the denial, we evaluate whether another level of review is available and what could support it.
EXPERIENCE SPECIALIZED DENIAL RECOVERY
Your First Qualifying Claim Is on Us
Let us work one qualifying denied infusion claim at no charge. To qualify, submit the claim to Mixon within 90 days of the date of service. If we recover payment, your practice keeps the full amount. There’s no obligation to continue.
1 Free
Qualifying claim worked at no charge
5%-15% Contingency Fee
On recovered payments, based on claim age and value
CONTINGENCY FEES START AT 5%
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NO RECOVERY. NO FEE.
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WE RECOVER. YOU PROFIT
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CONTINGENCY FEES START AT 5% ✦ NO RECOVERY. NO FEE. ✦ WE RECOVER. YOU PROFIT ✦
We Don’t Make Money Unless You Do
Mixon Revenue Solutions works alongside your billing team to investigate unpaid infusion claims, handle complex appeals, and pursue reimbursement that might otherwise be written off.
Our contingency fee is based on the claim’s age and value and applies only to the amount we recover. The rate is 5% for claims up to three months old, increases gradually for older claims, and reaches 15% maximum for claims one year or older. If we recover nothing, you owe no recovery fee.