Infusion Therapy
Infusion therapy claim denials, appealed.
Infusion carries some of the highest per-claim dollar values in outpatient care, and some of the most aggressive payer scrutiny: prior authorization, site-of-care steering, drug-versus-administration coding, and units disputes. A single denied infusion claim can be worth thousands, and the appeal is worth preparing carefully. Canopy does that.
Common infusion therapy denials we help appeal
- Prior-authorization denials on high-cost biologics and specialty drugs.
- Site-of-care denials where a payer steers to home or a different setting.
- Drug (J-code) and administration coding denials and units disputes.
- Medical-necessity denials on the therapy or the diagnosis linkage.
- Denials for missing step-therapy documentation.
- Wastage and NDC-related denials.
54% of denied claims are overturned when practices appeal them.
Source: Premier, 2024.
65% of denied claims are never reworked or appealed.
Source: MGMA.
A single appeal can cost $64 to $118 in staff time, which is why small claims get abandoned.
Source: industry / Premier.
You stay in control. We prepare the appeal.
Upload the payer’s denial or underpayment. Canopy analyzes it and prepares a complete, ready to file appeal package. You file it with the payer under your own letterhead, the payer pays you directly, and Canopy charges a flat success fee only on what you actually recover.
See the full how it works →See what your infusion therapy write-offs are worth.
Use the calculator to estimate the revenue you’re leaving on the table, then apply to get started.