Denials have become so customary in revenue cycle management that over 25-30 percent of the country’s total health care expenditures are direct transaction costs and inefficiencies associated with claim management, according to American Medical Association (AMA).
This calls for a new approach to denial management, one which is efficient and cost effective.
BillingParadise with a team of certified billers and coders has proven experience in denial management to comprehensively change the denial environment of your health system.
We are heavily invested in analytics and technology that fine tune our denial management processes. The access to analytics leverages the denial management team to track critical KPIs that boost the efficiency levels of processing denied claims.
As a billing company, we have come across many practices that are reluctant to appeal denied claims. Their reluctance stems from the belief that they may not recoup enough from appeals but instead incur administration cost on denial management.
Our cost eClinicalWorks effective denial management service has convinced many practices to change their mindset, as a result 90 percent of the denied claims that were audited and appealed by our denial management team were successfully reimbursed by payers.
Not many practices are familiar with the codes that need to be applied to a claim, and after the claim has been denied, insurance companies feel exulted, hoping that the practice would fail to appeal on a timely basis.
BillingParadise through a proactive approach restores the stalled denial management process of the practices, and significantly improve the cash flow and the bottom line of the organizations.
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.
We have an extensive payer rules checking engine that checks claims against payer rules.
We follow a cross functional strategy to analyze and categorize claims based on reason for denial and rejection pattern.
As our denial management support is available 24/7 you can be sure that the window never closes on any claim.
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