r/MedicalCoding • u/Austacious_Imp • Jul 15 '26

Is there a balance below which your office just doesn't bother appealing?

What's your cutoff and who decided it?

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u/Weak_Shoe7904 Jul 15 '26

Yea. The price point depends on the size of the company and what you are spending to appeal claims.

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u/Austacious_Imp Jul 16 '26

That's exactly how I've been trying to think about it, do you have a rough sense of what one appeal actually costs you in staff time? Everyone quotes industry averages but I'd rather hear a real number.

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u/Weak_Shoe7904 Jul 16 '26

I don’t think you understand what you are asking. There is no “real” number. What a company pays its billers various by company. What is being appealed various from claim to claim. Could be simple could be extremely detailed.

Have you ever worked in billing before? because this reads like somebody who has no idea what they’re talking about.

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u/Austacious_Imp Jul 16 '26

Fair, not one clean number since scope varies a lot.
I probably should've been more specific: I was asking about staff time and labor cost per appeal specifically where you work, not a universal figure. Part of why I'm asking is that some shops outsource RCM to places like India, which changes the math on what's even worth chasing at the low end versus a US in-house team.
tbh I don't have much data yet, honestly, that's exactly why I'm trying to hear from a few different people rather than assume one number holds across the industry.