At BillingParadise we go the extra mile dealing with denial cases, we believe that for the sustenance of revenue cycle profitability, an efficient denial management team holds the key. Any gap in denial management jeopardizes financial stability. As a care provider, preoccupied in providing the highest level of patient care, your organization can partner with us for end-to-end revenue cycle management or critical AR and Denial Management functions.
Billing Paradise with a certified team of billing and coding professionals guarantees significant improvements to your cash flow and revenue cycle.
Our proven experience in AR and Denial Management will generate greater income, minimizing denials and lost reimbursements, and maximize your efficacy gathering unpaid claims. We are committed to get you the highest possible return on investment.
As a first step for a successful claim resolution perspective, the denial management team will identify the reasons for the denial. The general practice followed by payers is to indicate the reason for denial, when adjudicated claims are returned unpaid.
The claims adjustment reason codes (CARC) as explained in an accompanying remittance advice remark code (RARC) are carefully scrutinized by the denial management team. All errors are diligently corrected, and the denied claims are resubmitted. We use online tools to create the best case argument for appeal. These consist of specialty-organization briefs that are specific to procedures, payer rules and guidelines. National coverage and local coverage determinations, besides template letters for specific appeal types are used denied claim resubmissions.
No matter how time consuming the process, our efforts are to improve the bottom-line of a practice.
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 webDMEMR.
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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Hire one/combination of services/all, we at BillingParadise will meet your needs 100%