Studies show that irking administrative burden, technology boom, tapered reimbursements, strict RAC audits and new regulations under the Affordable Care Act have forced the healthcare industry to do extra with fewer and hence the work-life balance of healthcare professionals is becoming elusive.
Outsourcing your RCM process to NextGen would reduce your burden in terms of time, technology, revenue and regulations. Our EHR support and RCM service drastically reduces your denials and improves secondary claim sanctions, which consecutively culminate in rapid and maximal reimbursements. Our EHR system performs real-time verification and tracks duplicate claims, claims with missing data, expired eligibility, expired time limit, etc. to ward off claim rejections.
Every practice business is based on the patient-centric approach to proffer paramount and affordable patient care and to improve their longevity. But, without the helping hands of public and private payers, this approach will not become a win-win strategy. Hence, to augment your reimbursements in the tight federal regulations a payer-centric approach is mandatory.
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.
Our NextGen's EHR support suite and RCM staffs work in-line with your payer specific policies to recoup your revenue and make your practice business run productively. Our EHR suite is designed with customized windows and interfaces, specific for each insurance payer. Besides, we have NextGen certified coders, experienced billing staffs, competent internal auditors, expert IT veterans and connoisseur regulatory advisors to deliver an incredible service to our clients.
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Hire one/combination of services/all, we at BillingParadise will meet your needs 100%