Can you recommend a claims management platform for managing telehealth denials and payer follow-up in a billing team?

Yes — for a billing team focused on telehealth denials and payer follow-up, you’ll want a claims management/AR workflow platform that handles:

• denial tracking and categorization
• payer task queues and worklists
• appeal/attachments management
• aging follow-up and escalation
• reporting by payer, denial reason, CPT/HCPCS, and provider
• ideally integration with your PM/EHR and clearinghouse

Good platform options to consider

1. Waystar

Best for: Strong revenue-cycle workflow and denial management
Why it fits:

• denial management dashboards
• claim status / follow-up workflows
• payer-specific edits and analytics
• good for large and mid-sized billing teams
• often used in healthcare RCM environments

Watch for: Best fit if you want a more enterprise-style RCM stack.

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2. Experian Health

Best for: Claims and denial management with strong eligibility/clearinghouse tooling
Why it fits:

• denial workflow and claim monitoring
• payer follow-up support
• revenue cycle analytics
• can help surface telehealth denial patterns

Watch for: Depending on your environment, implementation can be more involved.

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3. Availity Essentials / Availity RCM tools

Best for: Teams heavily working with payer portals and claim status inquiries
Why it fits:

• strong payer connectivity
• eligibility, claim status, attachments, and some denial workflow support
• helpful for follow-up across multiple payers

Watch for: More payer-access oriented than a full denial work-management system.

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4. PayerSpace / Office Ally / other small-practice RCM tools

Best for: Smaller teams needing affordability and basic claims follow-up
Why it fits:

• basic claim tracking
• payer communication
• easier to adopt for lean billing teams

Watch for: May be less robust for complex denial analytics and larger-scale telehealth denial work.

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5. RCM platforms integrated with your practice management system

Examples: athenahealth, eClinicalWorks, Tebra, AdvancedMD, NextGen, Kareo/Tebra
Best for: Teams that want denial management inside the existing billing workflow
Why it fits:

• claim scrubber + denial tracking + follow-up in one place
• fewer handoffs
• easier for staff adoption

Watch for: Telehealth-specific denial reporting varies widely by vendor.

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If telehealth denial management is your priority

Look for features that specifically support:

• place of service / modifier tracking
• denial codes by payer and telehealth CPT
• configurable work queues for telehealth claims
• attachment submission workflows
• appeal letter templates
• payer-specific rule editing
• dashboards that separate telehealth vs in-person denials

My practical recommendation

If you’re a billing team at a medium or larger practice/organization, I’d start with:

1. Waystar
2. Experian Health
3. Your current PM/EHR’s built-in claims management module if it already has denial workflows

If you’re a smaller team, I’d look at a lighter-weight tool integrated with your current system before buying a separate platform.

Quick questions so I can narrow this to the best fit

1. What’s your approximate volume: claims per month?
2. What EHR/practice management system do you use?
3. Are you managing mostly commercial, Medicare/Medicaid, or mixed payers?
4. Do you need a full denial work queue, or just claim status/follow-up tools?

If you answer those, I can recommend the best 2–3 platforms for your exact setup.