Helping you keep your facility open to care
At TRAF, it’s our mission to help healthcare providers keep their doors open and ensure patient access to medically appropriate care. Since 2000, we have navigated complex payor challenges to handle the toughest denials so your team can focus on what matters most: patient cared. The best part? We work at no risk or upfront cost to you—our success is only measured when we ensure you get the revenue you deserve.
Since 2000, we have navigated complex payor denials and resolved a wide range of issues—from clinical and technical zero pay denials, underpayments, corrective action plans, SPD coverage inclusions, public policy and legislative fights, and other types of denial issues. Our expertise enables us to quickly identify denial trends, address them proactively, and prevent further complications, ensuring your revenue cycle remains uninterrupted. By applying our deep knowledge of payor-specific rules and regulatory requirements, we help you recover the reimbursements you deserve while keeping your team ahead of the curve.
Emergency services denials occur when payors refuse to cover necessary treatments for patients experiencing urgent medical conditions, classifying them as non-emergent despite the critical nature of the situation. These denials violate state and federal laws that ensure emergency care must be provided immediately, without the need for prior authorization, and regardless of final diagnosis, to prevent any harm to the patient’s health or well-being.
Payors may request a refund for payments made on claims after conducting a retrospective review and discovering that the patient was not covered. However, laws prevent this practice, as once a treatment is authorized and provided in good faith, payors cannot rescind or modify their authorization, even if they later find discrepancies in eligibility or coverage.
