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Denial Management by Specialty

Every specialty faces unique denial challenges — different codes, different payer behaviors, different revenue impacts. ClarixHealth delivers denial management built for your specialty's specific billing complexity.

Orthopedics

10–15% denial rate · $1.3M–$1.6M annual unrecovered revenue

Surgical procedures, imaging studies, DME, and workers' comp claims create multiple denial triggers. ClarixHealth tackles CO-16, CO-29, CO-22, and prior auth denials specific to orthopedic billing.

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Cardiology

15–20% denial rate · $2.1M–$2.6M annual unrecovered revenue

The highest-denial specialty in healthcare. Medical necessity challenges on imaging, cath lab bundling errors, and EP coding complexity make cardiology denials among the most expensive to leave unworked.

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Physical Therapy

10–15% denial rate · $78K–$94K annual unrecovered revenue

Thin margins make every denied claim count. Authorization windows, medical necessity documentation, and the 8-minute rule create constant billing friction. ClarixHealth prioritizes PT denials worth the rework cost.

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Dermatology

8–12% denial rate · $181K–$227K annual unrecovered revenue

The cosmetic vs. medical battleground. Payers aggressively challenge medical necessity on lesion removals, biopsies, and surgical procedures. ClarixHealth tracks cosmetic classification patterns by payer.

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Gastroenterology

10–15% denial rate · $806K–$897K annual unrecovered revenue

Colonoscopy classification complexity, screening-to-diagnostic conversions, and high-value ERCP/EUS denials demand systematic denial management. ClarixHealth tracks conversion patterns and modifier issues across your practice.

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Recover denied revenue with AI-powered appeals.

ClarixHealth analyzes your denials, calculates win probability, and generates clinically-informed appeal letters in seconds — built for your specialty.