An efficient revenue recovery entails that appropriate payments received from payers comes through the first time claims are submitted.
If the claims do not get paid the first time they have been submitted, obviously they have been ‘denied’. These pose a problem, because they have to be reviewed all over again.
Meaning, coding and documentation have to be reworked and corrected, before claims can be resubmitted. This labor intensive process is time consuming and taxing, and can cost an organization a fortune.
BillingParadise offers an efficient and effective denial management program for FreeMed users.
Foremost, when ‘denials’ come to our denial management team, they do a thorough review of pre-bill coding and post coding related claim denials. This review upgrades our knowledgebase, so that coding errors are eliminated when new claims are submitted and reimbursed the first time they are filed.
Denied claims severely impact an organization’s cash flow, the industry average of denial rate is 5% to 10%. The best practice is to keep the denial rate under 5%.
Health organizations lose a chunk of revenue to denied claims. Lack of qualified staff prevents them from resubmitting the claims. These claims need professional intervention from a qualified denial management team. BillingParadise, with a proven denial management team can take the burden off your administrative staff resubmitting denied claims.
Our long years of experience processing denied claims will significantly improve the cash-flow of your organization, and will have a positive impact your revenue cycle.
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.
Now you need never miss a single cent! Our denial management experts view the ERAs/EOBs posted in the patient advisory screen of freeMED.
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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