Appeals worked in Parity
Behavioral-health denial appeals and resolution.
At Health Revenue Intelligence (HRI), every appeal is worked in Parity, our appeals workspace.
Cause first
Seven
diagnostic
checks.
One workspace
From document library to follow-up
Our approach
How we work appeals
Priced in the open
First-level appeals are worked as part of the billing itself. When a claim warrants second-level or external review, that scope, with its price, goes in writing before anything starts.
Argued from the record
We build medical-necessity and behavioral-health-parity arguments from the payer's own denial letter.
Deadline-controlled
We track every deadline, address and requirement and confirm each against the denial letter before submission.
Followed to resolution
Every appeal stays in follow-up until it is resolved.
Before you appeal
The 7-Point Diagnostic Framework
We apply seven diagnostic checkpoints to stuck claims to find what caused the denial. The appeal then answers that cause.
- 01
Rejection codes
The payer's own denial and adjustment codes, read for the root cause.
- 02
Remittance analysis
The ERA, the electronic remittance advice, shows how the claim was adjudicated: what paid, what denied and what was adjusted down.
- 03
Claim history
The full submission-and-response timeline. A claim denied three different ways over six months is telling you something one letter can't.
- 04
Payer relationship
Network status, out-of-network handling, carve-outs, and routing: where this provider stands with this plan.
- 05
Provider enrollment
NPI, Tax ID, and submitter authorization, checked against what the payer has on file.
- 06
Code integrity
We review CPT, revenue code and taxonomy together. Behavioral-health claims depend on the combination.
- 07
Claim build
Authorization, dates, and clinical detail, checked as a whole.
What wins an appeal
A denial is an objection with an answer.
A denial has to state the grounds for the decision, and a good appeal answers those grounds, in the payer's own language, with the record to back it.
The payer's yardstick, confirmed
Level-of-care decisions may use service-intensity tools such as LOCUS, CALOCUS-CASII, ECSII, or The ASAM Criteria. Frameworks differ by payer. We confirm the plan's policy, version and dates before building the case.
The record against the objection
We identify the dates and level of care at issue and connect the strongest clinical and administrative evidence to the payer's stated reason. A long record that never answers the objection does not win.
Upstream failures, checked early
In Experian Health's 2025 provider survey, prior-authorization problems triggered 35% of denials and incomplete or inaccurate registration information triggered 32%. Both are checks a billing team runs before the claim goes out.
Built from three documents
Our appeals are assembled from three documents: the denial letter, the plan's Evidence of Coverage and the payer's own medical-necessity policy. The federal Mental Health Parity and Addiction Equity Act backs the argument when a plan treats behavioral health more strictly than medical care.
Primary references, checked August 2026: AACAP service-intensity policy · The ASAM Criteria · Experian Health denial survey · CMS appeal rights · CMS mental-health parity overview.
The appeals workspace
About Parity
Parity's eight steps keep every document, deadline and argument for a denial in one case file.
A case moves through the steps in order: documents first, then the patient, provider, and denial detail, then the evidence packet, the submission, the letter, and follow-up.
Not legal or medical advice, and not a substitute for filing. Parity helps our team organize and draft the appeal, and patient data stays in a private case file.
Why it matters
What a won appeal pays
A won appeal pays for care your team already delivered.
Next step
Start with the denials.
Send us the denials that keep coming back. They go through the diagnostic first, and we build the appeal inside Parity at the level the record supports.
Last updated: October 25, 2026