Claims Others Give Up On—We Get Paid
At EMK Medical Billing, we specialize in recovering revenue from delayed, denied, and complex insurance claims—often ones providers assume are lost.
Key Statistics
Many of these claims were previously denied, delayed, or considered uncollectible. Without intervention, they would have been written off.
Why This Matters
Most providers don’t have the time or resources to chase down complex claims.
Insurance companies delay, deny, and misprocess claims every day—and without aggressive follow-up, that revenue is often lost.
Detailed Follow-Up Success Stories
Insurance: UHC
Billed: $147,874
Recovered: $145,894
Time claim was in system: 33 weeks
The Situation:
This claim experienced repeated delays, missing records, and miscommunication within the payer system. At one point, payment was even issued to the wrong address.
What We Did:
Over the course of several months, our team:
- Made repeated follow-up calls to track claim status
- Identified missing and mishandled documentation
- Resubmitted the claim when required
- Escalated the case multiple times
- Corrected payment delivery issues
The Result:
Nearly full reimbursement recovered
Claim resolved despite multiple processing failures.
Without persistent follow-up, this claim would likely have gone unpaid.
Insurance: Aetna
Billed: $905,493
Recovered: $940,311
Time claim was in system: 37 weeks
The Situation:
A high-value claim was denied for authorization issues, despite being emergency services, mishandled as a duplicate, misclassification of claim type, and delayed due to missing documentation.
What We Did:
We stayed actively engaged throughout the lifecycle of the claim:
- EMK conducted a full claim audit
- Corrected incorrect denial reasoning
- Ensured medical records were properly attached
- Reopened and escalated the claim through appeals
- Monitored multiple review cycles and pushed for resolution
The Result:
Full reimbursement secured Additional interest recovered
Total payment exceeded billed amount.
This claim was at high risk of being written off before our intervention.
Insurance: UHC / WellMed
Amount Billed: $420,921 over 3 claims
Recovered: $420K+ across claims
Time claim was in system: 35 weeks
The Situation:
The primary claim was denied due to an eligibility discrepancy, with the payer stating the patient’s
coverage was not active on the original date of service. Additional claims experienced multiple reprocessing cycles, backouts, and delays.
What We Did:
- Identified the root cause of the denial
- Corrected and resubmitted claims with accurate data
- Followed through multiple reprocessing cycles
The Result:
Full or near-full reimbursement across all claims
Accurate corrections and persistence turned a denial into full payment.
Insurance: Aetna
Amount Billed: $193,870.64
Amount Recovered: $1G3,114.48
Time claim was in system: 46 weeks
The Situation:
This claim was initially not found in the payer’s system for weeks after submission. Once located, it faced multiple complications, including incorrect billing address instructions, processing delays, undervalued payment estimates, and repeated review cycles. At one point, the claim was projected to pay significantly less than expected, and later was even marked as denied.
What We Did:
Our team stayed actively engaged over several months to push the claim forward:
- Identified submission issues and redirected the claim to the correct processing address
- Tracked and confirmed claim receipt after refiling
- Followed up consistently through multiple processing stages
- Requested re-reviews and escalated when the claim stalled
- Corrected missing documentation and ensured it was properly entered into the system
- Continued follow-up even after conflicting claim statuses, including denial
The Result:
Recovered nearly the full billed amount
Overturned processing errors and low reimbursement projections Secured payment after months of follow-up and escalation.
This claim went from “not on file” to fully paid—something that would not have happened without persistent follow-up.
How Much of Your Revenue Is Being Left Uncollected?
Every unresolved claim represents lost revenue. Many of the cases we recover were previously written off or considered uncollectible.
If your team doesn’t have the time to pursue complex claims, EMK can step in and recover what’s rightfully yours.
Let us review your aging or denied claims.
We’ll show you what’s recoverable.
We also have this chart we would like to incorporate in whatever way would be best. It represents the percent of claims from various medical insurance payers that we have been paid for complex, previously denied claims:
Many billing companies stop after submission. We don’t.
This data reflects our ongoing work—tracking, correcting, and escalating claims across multiple insurers until payment is recovered.
A large portion of these claims would have remained unpaid without consistent follow-up.