Denial Management Services
Our process leverages advanced data analytics to proactively identify and resolve billing issues, reduce future denials, optimize revenue cycles, and enhance cash flow and patient care...
The details below will help you understand how we can help!
Do You Often Find Yourself Drowning in Claim Denials?
We Will Provide Your Practice the Following Services:
Our Denial Management Services
- Proactive tracking and follow-up on claim denials to ensure timely resolution and payment
- Detailed reporting on denial trends to help mitigate future claim issues and improve overall efficiency
Our Process for Denial Management
- Initial assessment and classification of denials to determine root causes and prioritize resolution efforts
- Continuous monitoring and adjustment of strategies based on feedback and performance metrics to enhance effectiveness
Benefits of Using Our Denial Management Services
Strengthen Position with Payers
Payers are designed to avoid paying, but a data-driven, proactive denial management approach ensures they can’t get away with it as easily. It’s about leveraging knowledge, technology, and persistence to make them pay what they owe—fasterIdentify the Root Causes of Most Denials
Analyzing denial trends helps identify common reasons for denials, allowing you to address the root causes and prevent future issuesIdentify Data-Driven Improvements with CARC and RARC Analytics
Harnessing data analytics in revenue cycle management enables practices to pinpoint inefficiencies, optimize workflows, and improve reimbursement rates. A crucial aspect of this approach is analyzing Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs) to identify patterns in denials, underpayments, and revenue leakageWhat's the NEXT STEP once you address any issues you have with your current Denial Management Process?
When you work with our team to streamline every aspect of your Revenue Cycle Management (RCM) Process to ensure that you are maximizing revenue, reducing inefficiencies, and eliminating costly errors, your practice will benefit in a magnitude of ways! Our proven process includes 12 key steps within the medical billing lifecycle that our team can help you implement or manage on your behalf - let's connect and discuss your options TODAY!
Here are Some Frequently Asked Questions Our Staff Gets...
Is there a long-term contract?
We offer a 90-day termination clause in all our contracts, allowing flexibility for our clients. While the traditional approach was to use long-term contracts to cover ramp-up costs, we now structure those costs based on the specific work needed, eliminating the need for long-term commitments
How soon can I get started?
If there are no termination clauses to navigate and you can facilitate administrative control, we can get started right away. Our team is prepared to ensure a smooth transition with minimal disruption to your operations
Is it painful to transition to a new billing company?
Transitioning to a new billing company can be challenging, but a lockbox can help streamline the process by consolidating payments from multiple sources into a single location. While there may still be some initial setup and coordination required, using a lockbox minimizes payment disruptions and simplifies cash flow management, making the transition smoother and less painful. Proper planning and communication with payers can further reduce potential issues
How long will it take for me to see improvements?
Our reports are reliable, but the timeline for seeing improvements depends on several factors, including the quality of prior data and the specific changes implemented. While an apples-to-apples comparison is ideal, we often inherit incomplete or inconsistent data, requiring time to normalize and establish accurate benchmarks. Typically, meaningful trends become apparent within a few billing cycles
Can you work with my current staff?
We always strive to incorporate existing staff whenever possible, as long as they are willing and able to contribute effectively. We understand that external billing vendors can sometimes be met with hesitation, but our goal is to work collaboratively and ensure a smooth process while valuing the expertise already in place. Finding good talent is challenging, so we’re happy to work with your current staff to maximize efficiency and success
How much do you charge?
Our pricing is typically based on a percentage of collections, which varies depending on your practice's volume and specialty. Patient billing, including mailed statements, text, and email bills, is charged separately at cost, with digital options often being more affordable. Provider credentialing and enrollment are offered à la carte, and we also provide a wide range of optional services, from appointment reminders and eligibility checks to consulting and utilization reviews. For smaller practices, we have a minimum fee designed to be affordable. Let’s discuss your specific needs so we can provide a tailored quote