Denial Management is one aspect of Revenue Cycle Management, which very few health organizations pursue with extreme diligence. It needs to be understood that failure to efficiently work denials from insurers eventually results in lost revenue.
BillingParadise with a certified team of billing and coding professionals identifies the root causes of denials to manage it with great efficacy. Every aspect of denial management workflow is closely monitored to ensure that the stalled cash flow of the organization is successfully restored.
The denial management team through advanced analytic tools classifies denials by reason, source, cause and other discernible factors. Denial management strategies are effectively developed and assessed.
In accordance, the team implement these strategies, which at times requires patients and referring physicians to be engaged, for setting up an effective appeal to reverse unfair denials.
Using proactive and time tested techniques with best practices, we successfully turn the corners managing denials to facilitate a healthy bottomline.
In our long association with health organizations, we find that their denial response workflow never takes off immediately as soon as they learn about the payers decision. Possibly, because of non-availability of a dedicated denial response team. This delay results in appeal deadlines being missed.
BillingParadise, through its dedicated efforts organizes and expedites the management of denial management cases. We follow a methodical workflow, for example, if we come across code related denials, these are automatically routed to our certified coders, who swiftly work on them, before they are resubmitted to the payers. Our streamlined denial management workflows have restored the cash flows of many healthcare organizations, and improved their bottom line.
All denials are routed to the denial analysis department. Denials are segregated into line item and full denials
DenialAnalyzer, our denial management and reporting app, gives you realtime insights
All claims are categorized into different follow-up groupings.
We work with all federal and commercial payers and have strong knowledge of their payment mechanisms
Redundant processes are automated. This cuts back on cycle times. Recover money faster.
Software that identifies, isolates, quantifies and categorizes denials to help you lower your denial rate and spot revenue leakage sources.
This is what sets us apart
||Your Denial Provider|
StatsBefore we delve into processing denied claims, we need to know the initial denial rate, dollar rate, and claim rate. This will help us lower denial rates, and improve the process.
Organized ProcessLosing track of the denied claims will lead to diminishing revenue. If the number of denials keeps increasing, it will lead to revenue loss and severe administrative problems. Thus, an organized denial management process can help track all claims, using HIPAA certified tools and technologies.
Denial TrendsQuantify and categorize the denials by tracking, evaluating and recording the denial trends. We consult your physicians and payers for information. This helps reduce claim denials and improve compliance. We also use data and analytics to collate and find reasons for claim denials, and identify core issue to rectify them.
Completing denials within 24 to 48 hoursWhenever a claim is denied, we follow a validated process to get the denial corrected, preferably within 24 to 48 hours. This is made possible by following an established workflow which will track the claims as they enter and leave your system.
Quality and quantityOur 24 hours active resources enable us to provide resolution through analysis and calling. This helps segregating quality claims, while eliminating claims that do not need to be resubmitted. .
Tracking the progressThis is one of the most important aspects of denial management. It helps to know which areas are doing well and which need further improvement. Both the wins and losses will be documented for future analysis and improve the systems efficiency. Automating denial management processes also give plenty of time to rework on rejections.
Our denial management and reimbursement specialists work hand-in-hand to resolve the denial conundrums through a multi-faceted approach:
You may think that taking the bull by the horns is difficult if it comes to the denial management and claim appeals. But, our denial management experts know the ropes of the denial resolution process and we'll effortlessly transform your denied superbills into dollars.
Our RCM experts, reimbursement specialists, claim auditors, compliance officers are well acquainted with the payer policies and thus, we could assure you with a payer audit-proof reimbursement.
Succinctly, our brains are programmed to track claim denials and perk-up your practice's success rate for claim appeals.
BillingParadise has helped several Epic users brush aside their billing hurdles and run a more profitable practice, inline, with regulatory guidelines.Read More
Medical coding is becoming increasingly complex. An average coder, who assigns codes without in-depth analysis can do your practice more harm than good. Epic users can now code right!Read More
We take care of your front end and back end revenue cycle processes. Right from appointment scheduling and eligibility verification to claim analysis and denial resolution, our Epic revenue cycle management services, have you covered. We help you leverage and extract the most out of the staff, technology and workflow of your medical practice.Read More
AR calling is more than just making calls to insurers and leaving home at six. You need AR callers who are persistent, informed and quick.We work with Epic users every single day and offer flexible, practice specific support.Read More
We have specialized teams of medical billers and coders who hold speciality specific certifications to handle your billing and coding tasks