An effective and efficient management of denials entails setting up a process of collecting, tracking, reporting, trending, forecasting, and measuring data. These elements help in managing revenue loss.
It is not in the realm of health organizations to set up such an effective revenue management structure, given that patient care is their top priority, and any drawback on care would mean a drop in revenue of the organization.
Denial claim management is better left to a professional billing company, which is adequately staffed with certified billers and coders, and with access to reporting and analytic tools.
BillingParadise, with a proven experience of 10+ years in revenue cycle management has partnered with notable health organizations, lending them denial management support. All billers and coders of our company are certified, with years of experience working in tandem with payers and providers.
We follow the best practices in revenue cycle management, with denial claims routed to work queues assigned to the denial management team. Beginning with establishing denial management strategies, the team foremost identifies the root cause for which the claim was denied.
The team categorizes the identified reasons, and based on the experience of billers and coders working with specialties, denied claims are distributed for corrective actions. After the inconsistencies in the claims are corrected, they are resubmitted to the payers.
An effective tracking mechanism has been developed by our company to track the status of the resubmitted claim, with a staffer dedicated to follow them diligently.
BillingParadise also provides a checklist to the health organizations, detailing top denial reasons, and how this can be prevented for filing future claims.
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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 prognocis emr.
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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BillingParadise has helped several Epic users brush aside their billing hurdles and run a more profitable practice, inline, with regulatory guidelines.
Read MoreMedical coding is becoming increasingly complex. An average coder, who assigns codes without in-depth analysis can do your practice more harm than good. Epic users can now code right!
Read MoreWe take care of your front end and back end revenue cycle processes. Right from appointment scheduling and eligibility verification to claim analysis and denial resolution, our Epic revenue cycle management services, have you covered. We help you leverage and extract the most out of the staff, technology and workflow of your medical practice.
Read MoreAR calling is more than just making calls to insurers and leaving home at six. You need AR callers who are persistent, informed and quick.We work with Epic users every single day and offer flexible, practice specific support.
Read MoreOptimize the many moving parts of your revenue cycle with BillingParadise’s Epic revenue cycle management services. Our certified revenue cycle specialists will improve the compliance and performance of your Epic RCM processes.
Read MoreWe have specialized teams of medical billers and coders who hold speciality specific certifications to handle your billing and coding tasks
Hire one/combination of services/all, we at BillingParadise will meet your needs 100%
BillingParadise employs trained personnel to manage your claim auditing needs. All claims are thoroughly audited and quality checked before the bills are sent for reprocessing. Batches of claims are diligently checked for incorrect codes/errors/missing information before sent for processing.
At BillingParadise we have designed our audit workflow that produces quality centric audit reports the fastest way possible. Auditing and recovery occur simultaneously, and reports are produced based on your necessity. Every flaw is flagged & rectified in tandem. The entire workflow is streamlined and optimized.
BillingParadise provides you the most optimized and cost effective software.The ClaimBridge is a turnkey software solution. The software is automated and analyzes claims in batches. Easily deployable, seamlessly scalable & can be maintained & updated. Our tech helps you conserve your valuable resources and boosts your revenue.
Hire one/combination of services/all, we at BillingParadise will meet your needs 100%
BillingParadise employs trained personnel to manage your eligibility denials. This service is made available for you to avoid such denials. Verifications are done by our specialists prior to services rendered. Every criteria from pre-certification to patient due is checked and thoroughly verified.
At BillingParadise we have designed our eligibility verification workflow to be streamlined and highly productive. We ensure that all information regarding your patients current eligibility status is made available to you the instant you require it. Eligibility checks are done in batches and are also made available to you on demand.
BillingParadise provides you the most optimized and cost effective software. The software can cross-integrate across payor systems and offers you complete interoperability for you to keep track of your patients eligibility status. Eligibility checks are done on demand or through scheduled batches. Hire us and avoid eligibility denials permanently.
Hire one/combination of services/all, we at BillingParadise will meet your needs 100%
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Work with medical billers who understand your EHR's billing process backwards and forwards
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