20+
Years of Experience
70%
Reduction in Denial Rate
30%
Reduction in Aged A.R
Ensure Optimized Financial Stability through Effective Denial Management
Managing denied claims is crucial in ensuring prompt reimbursement and maintaining a steady cash flow. Denial management is an integral part of the medical billing process. Our denial management services focus on identifying, analyzing and resolving the root cause of claim denials, ensuring minimal disruption to the practice’s workflow and allowing healthcare providers to focus on delivering quality patient care.
Why Do You Need Denial Management Services?
Claim denials are one among the primary reasons that affect the financial stability of healthcare practices. Your claim denials may be a direct result of staff oversight that includes, missing documentation, coding errors, or lack of expertise and resources to manage the process effectively. You need an efficient system in place to ensure optimum revenue, prompt payments and reduced administrative hassles. By leveraging advanced technology and decades of industry expertise, we streamline the complex process ensuring all claims are addressed on time, thereby improving overall operational efficiency.
Benefits of Partnering with Us
Optimized Workflow
Automate the process and free up your resources to focus on tasks that matter.
Increased Revenue
Minimize revenue loss by successfully recovering denied claims.
Error Reduction
Our detailed root cause analysis mitigates any claim denials in the future.
Improved Cash Flow
Enhance your revenue cycle with timely resubmissions and faster reimbursements.
Regulatory Compliance
Stay compliant with the ever-changing industry regulations and mitigate claim rejections.
Our Denial Management Process
1
Comprehensive Claim Review
Claim Resubmission
4
2
Denial Categorization
Escalation of Denied Claims
5
3
Appeal Strategy
Feedback & Prevention
6
1
Comprehensive Claim Review
2
Denial Categorization
3
Appeal Strategy
4
Claim Resubmission
5
Escalation of Denied Claims
6
Feedback & Prevention
Comprehensive Claim Review
We conduct an audit of your denied claims to identify common issues and the root cause.
Denial Categorization
We categorize claims based on reasons of their denial and prioritize those with the highest financial impact.
Appeal Strategy
After understanding the denial reasons, our team will prepare a strategy on resubmitting claims, collating necessary documentation and making corrections.
Claim Resubmission
Verified claims are then resubmitted to payers, ensuring all conditions are met and continually monitored, to warrant timely approval and payment.
Escalation of Denied Claims
If the resubmitted appeal still gets denied or wasn’t properly resolved, we will escalate the case, following the established procedures.
Feedback & Prevention
Our system provides regular reports with detailed insights, to help implement denial prevention strategies and enhance future claim submissions.
Our Service Highlights
- Comprehensive Denial Analytics
- Documentation Review
- Denial Prevention Consultation
- Denial Appeals and Resubmissions
- Regulatory Compliance Support
- Custom Reporting and Insights
Affordable and Flexible Pricing Options
Our cost-effective pricing packages are designed to enhance your medical AR management workflow.
Full-Time Equivalent
In this model, services are billed based on the equivalent cost of a full-time employee (FTE) for a specified duration, usually monthly or annually.
Per Verification Billing
Like an FTE model, a person is dedicated to your practice. Perfect for a practice that is busy. They work as an extension to your business.
FTE/Per Verification Billing
This option is ideal for a practice that is unsure about their work requirements. This can have per request pricing for eligibility and other functions.
FAQs
What types of denials do you take care of?
We handle all types of claim denials especially ones related to incomplete documentation, prior authorization issues, and coding errors. Our team analyzes, identifies the issue and addresses it based on the cause.
How can denial management benefit my practice?
This service can mitigate revenue loss by making sure that the denied claims are promptly recovered and resubmitted. This leads to a better revenue cycle, reduces administrative overload and ensures your practice remains compliant with industry regulations.
How much time does it take to resolve denied claims?
The resolution time depends on the complexity of the denial and the payers’ guidelines. Regardless, our team works round-the-clock to ensure a faster turnaround time through timely follow-ups, ensuring quick reimbursements.
Can you prevent future claim denials?
Yes. We are capable of strategizing denial prevention plans by working with you and identifying common errors and offering the best solution for improving claim submissions. Our insights will help reduce future denials and improve cash flow for your practice.