Denial Management is one of the core challenges that revenue cycle management professionals confront. Despite the level of attention it receives, providers still write off 3% to 5% of their revenue to denials each year. BillingParadise through a dedicated team of denial management professionals ensures that health organizations are appropriately reimbursed through a comprehensive denial management plan. We utilize custom tools to simplify and automate the process of denial management.
Our custom tools are designed for seamless integration and convenience of reporting that enable viewing denials in one screen on a transaction-by-transaction level. This facilitates viewing transactions that are denied for a specific group or reason code. The tool also enables printing out an EOB for a specified claim.
Using a denial analysis report, the denial management team isolates the types of services and codes that generate denials in the system. The tool displays detailed information about denial trends, by reason code, top 10 denials. We use the analysis data to appropriately code future claims to minimize denials.
The tool automatically categorizes denial claims for correction and resubmission. It allows us to edit claims, process them for resubmission. We follow a denial workflow pattern that meticulously defines the process. The performances targets of our denial management team are benchmarked. Our denial follow-ups guarantee improved cash-flows and revenue bottom line.
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
| Recommended | ||
| Workflow | BillingParadise |
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. |
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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. | ||
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Now you need never miss a single cent! Our denial management experts view the ERAs/EOBs posted in the patient advisory screen of nuemd.
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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