Denials Management

Healthcare communities are facing ROI challenges on denials management and reimbursement analysis solutions. These are projected to only worsen in coming years. Providers need to streamline and automate their processes to improve revenue recognition.

Our Denials Management solution streamlines recovery efforts through batch appeals, with proven results for increasing clean claims and first-pass yield by 11%. It in turn has a direct effect on the financial reporting as it maintains an accurate statement of revenue, cash collection, and posts contractual allowances for timely net accounts receivable information.

Additionally, it improves reimbursement forecast accuracy and contract with all payers and care settings. It Identifies underpaid claims and categorizes denials to understand true revenue potential and close the gap between actual and expected reimbursement. The solutions also helps the healthcare community focus on its core activities by identifying payment errors and streamline collections.

A platform-based solution which provides secure, web-enabled software access without the need for a large-scale, expensive software with below features:

• Precise calculation engine pinpoints all payment discrepancies to reveal true revenue potential.
• Advanced workflow functionality boosts collector agility and ability to coordinate seamlessly across departments to overturn more denials and increase underpayments recovery
• Robust financial dashboards and reporting tools allow quick identification of patterns and trends in payment performance in order to find and fix root causes of discrepancies.
• Sophisticated contract analysis and modeling arms staff with data and scenario analysis to level the playing field with payers, improve negotiations, and increase contract yield

Benefits