Revenue Cycle Management in its entirety is a daunting prospect, no matter how skilled a professional, the mental resources of even the most experienced can be severely tested. Ask any professional, which aspect of RCM they find most challenging, and nine out of ten will say ‘denial management’.
Denials are often glossed over by health systems, but they happen to be one of the major areas of revenue leakage. It requires a proactive management approach to stem the flow of precious dollars from the revenue cycle of an organization.
BillingParadise through a robust denial management program restores efficiency in health systems denial management processes. In order to restore and maximize claims reimbursement revenue expeditiously, we follow best practice denial management strategies.
Using data analytic tools and relevant technologies, our team based approach has improved the cash flow of many practices and hospitals. The denial management team carefully analyzes different denial reason codes, and the quantum of claims associated with these codes. After a thorough analysis, our certified coders make necessary corrections to denied claims, and resubmit them to the payers.
We also share the analytics data with different departments of the hospital for process improvements to minimize future claim denials. BillingParadise through a combination of automation and certified human resources guarantees positive results to improve your organization’s cash flow, and boost the bottom line.
Our experienced denial management team re-works claim denials, no matter how big or small the volume, we do it with great diligence making sure that your health system receives every dollar health insurance companies are obligated to pay.
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 greenway .
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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