Efficiency and speed in denial management is the key to faster reimbursements. In order to put that into practice, automation tools play a significant part in its successful implementation. Kareo’s medical billing software has the capability to individually identify and rectify the principal cause of denial and rejection.
Denials can automatically be flagged for review and resolution, before they are resubmitted to payers. BillingParadise have years of experience partnering with health systems using Kareo medical billing software.
The denial management team at BillingParadise will log into the Kareo EHR, and submit your electronic claims to Kareo’s clearinghouse service. We thoroughly check the format of the electronic claims to see if there are any inconsistencies. We will get the claims validated to payer-specific formatting requirements, making sure that all information in the filed claim is accurate and consistent.
In case your hospital or practice staff have already filed the claims, and if you are confronted with rejected or denied claims, our denial management team will log into the Kareo EHR to access the system’s categorized ‘Rejected’ or ‘Denied’ claims.
Having done that, the team will look for insurance notes explaining the reasons for rejections or denial. The claims accordingly will be corrected and resubmitted to the concerned payers.
Billing and coding processes are extremely demanding and time consuming, it can severally impact patient care. Even small inconsistencies in claim documentation workflows lead to denied or delayed payments, costing organizations a fortune reworking and resubmitting the claims.
The team at BillingParadise scrutinizes every claim diligently to make sure that your health system meets the compliant demands of new payment models, rules and regulations of which continually keep changing.
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 kareo.
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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