Whatever be the reason, most claims denials are a direct result of staff oversight. We at BillingParadise are equipped with the best medical coding and billing professionals, hand-picked for their expertise in the domain. These professionals are perpetually enrolled in continual staff education initiatives, so as to possess the most up-to-date knowledge on the billing and coding guidelines.
Insurance companies in general have an approved list of procedures or diagnosis combinations that they would pay for. BillingParadise maintains a database of such approved combinations by different insurance companies and is up-to-date on the same. Our highly endorsed coders ensure that the highly paid and highest approved combination of procedure and diagnosis codes are used to ensure maximum payment and instant approval.
Denial Manager gives complete and immediate visibility into each claim and denial
Apart from our successful denial management service workflow, we provide our denial management templates
that can categorize, sort, and identify the different types of denials according to priority saving you time and energy.
Decrease in the denial rate.
Productivity improvement.
Reduced operational costs.
Reduction in aged A/R.
Reduction in DNFB accounts.
Achieve net collections.
Identify chances to rectify or correct the problems that cause claims to be denied by insurance companies.
Categorize denials by reason, cause, source, and other underlying factors.
Monitor the root causes and construct effective denial management service strategies.
Implement preventive measures and other post-denial techniques to effectively appeal and resolve unfounded denials.
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.
Appeal forms for most of the payers are listed. If the required appeal form it is uploadable?
Denied claim information is automatically populated in the appeal form.
The audit control system tracks the entire claim history from the first submission to the end of denial or payment. So no need for jumping from PMS, and EHR to the denial tool.
In case of rejected claims we extensively aid in identifying the issues that led to the rejection and those need to be fixed. We also take up the added responsibility of identifying the core of the rejections thereby trying to avoid the recurrence of errors leading to denials.
BillingParadise also maintains an internal database of rejected and underpaid claims of various insurance carriers to serve as an expeditious source of reference for similar cases in the future. This drastically cuts down the denial management time-frame and puts the money where the mouth is-in the physician's pockets.
And in most cases, the in-house staff doesn't aggressively follow up on the denial with the payer and invariably the claims come to be written off. All this can be avoided only with a dedicated and enthusiastic denial management team that expertly teams up with certified coders and other billing professionals to resolve the situation at the earliest and to its best. At BillingParadise, we deploy a comprehensive tracking system for regular follow-up of deferred and rejected claims. We exploit a regular follow-up strategy by tracking the claims submission and settlement phases ensuring that your collections are on track.
There may be varied reasons for a claim's rejection, it may be a modifier that is out of place or a combination of codes not allowed under the CCI edits, or it just could be that appropriate pre-authorization for the particular procedure, as mandated by the patient's carrier was not obtained at the first instance of the patient coming in. Reasons may be multiples of any number whereas the solution is one – BillingParadise.
Just make a call @ 1-(888)-571-9069 to know more about our services.
It eliminates the need to run multiple reports. View Denial summaries at a glance
We have specialized teams of AAPC certified medical billing specialist who hold speciality specific certifications to handle your billing and claims management
