Management of Claims & Denials

Receiving reimbursement for services is becoming increasingly difficult.  Rules and processes from payers have become more and more complex resulting in a higher rate of denials, underpayments, and lost claims. 

The claims management process begins during admissions when staff collect the necessary patient and health insurance information. The process ends only when the appropriate payment for the services rendered has been received.

Invalid or incorrect patient insurance eligibility data is one of the most common reasons for front-end claim denials.  We provide tools to ensure and verify insurance eligibility prior to services being provided.  These tools not only reduce registration related denials, but also maximize cash at point of service.

Because of the complexity and processes of payers, denials are inevitable.  Our dedicated teams of claim follow-up and denial appeal specialists have the knowledge and experience to make sure denials are handled quickly and effectively.  We provide detailed denial management reports to give you insight into top codes being denied as well as which payers are the most problematic. This information helps you manage your practice(s) effectively to reduce the denial rate and increase cash.