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If claim denials or recurring claim denials are not resolved, a healthcare organization will suffer from a substantial loss in cash flow.
We specialize in the medical billing aspects of AR & Denial Management Services, including identifying outstanding balances, analyzing denial reasons, taking appropriate corrective action, and following claims through resolution, blending hands-on AR management with structured denial management.
We don’t just run aging reports, we find out why revenue is outstanding and assists in implementing processes to minimize the chance for recurring claim denials.
Our denial management solutions don’t just involve resubmitting claims, we monitor denial patterns by payer and reason code to address recurring issues at the source, not singular claims.
Here is how we make the best claims and denials into resolved, collected revenue.
The first step in denial management is to make sure that outstanding claims are reviewed and denials are grouped by reason and by payer.
We don’t just submit the same claim for rejection again, we solve the underlying problem of the denial.
Active AR management includes appealing denied claims and resubmitting them with supporting documentation.
Reporting is on-going, identifying what is outstanding, why, and how it is being addressed.
See answers to frequently asked questions from healthcare providers regarding our medical billing, coding and revenue cycle management services.
Denial management procedures are designed to determine the causes of claims being denied, correct or appeal those claims, and then investigate the underlying causes and take steps to avoid the same claim being denied again.
High dollar and time sensitive claims should be prioritized; best practices involve categorizing denials based on why; using root cause analysis to solve the root problem, and appealing denials as soon as they occur.
Check for transparency in the reporting of aging analyses, documented appeals process and a history of fewer AR days, not just reporting on unpaid balances.
The distinction lies in the methodology: resubmitting denied claims vs. getting to the root cause of the denial and correcting it.
It’s essentially a systematic approach to tracking, correcting, appealing and analyzing declined insurance claims to maximize revenue and minimise future denials.
Claims that are old don’t gather. Capable denial management team transforms outstanding accounts into real payments.
Your trusted partner in medical billing and revenue cycle management.