Denial appeals · DME suppliers
You delivered the equipment. Getting paid for it shouldn't be the hard part.
DME claims carry the heaviest documentation burden in healthcare — and payers exploit every gap: LCD criteria, same/similar history, proof of delivery, prescriber paperwork. We turn that burden back into an argument.
Free for your first 10 claims. Then 15% of recovered revenue only — upheld denials cost you nothing.
The denials you're seeing
We know these EOBs by heart.
| Denial | What the payer said | Why it's often winnable |
|---|---|---|
| CO-50 | Not medically necessary — LCD criteria | LCD/NCD criteria are public and specific. We map the prescriber's documentation to each criterion and demand the payer identify which one supposedly failed. |
| CO-16 | Missing documentation — SWO, F2F, prescriber notes | Frequently curable: the document exists and wasn't matched to the claim. We identify, attach, and resubmit. |
| Same/similar | Equipment 'already on file' | History errors, lost/stolen/irreparable exceptions, and condition-change documentation defeat many same/similar denials. |
| CO-197 | No prior authorization | Retro-auth provisions and urgent-need exceptions, argued from plan language. |
| Proof of delivery | POD disputes & audits | Delivery documentation standards are precise; meeting them on appeal reverses recoupments. |
How we fight them
Specialty-specific arguments, not form letters.
Criteria-by-criteria appeals
DME wins are checklists, not essays. Each appeal addresses every LCD element with a document citation — leaving the reviewer nowhere to hide.
Recoupment responses
TPE/RAC-style recoupments respond to the same evidence discipline. Contingency means we fight clawbacks only when winning is realistic.
Dollar-weighted priority
Wheelchairs, CPAP, oxygen — we sequence high-dollar appeals first so cash returns fastest.
Free 10-claim pilot
Find out what your write-offs were actually worth.
Tell us a little about your practice. We'll reply within one business day with the BAA and a secure upload link.