Claims Denial Management2019-03-25T17:28:01+00:00
CLAIMS DENIAL MANAGEMENT

Make denials a thing of the past with our 96% first pass rate.

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DENIAL  MANAGEMENT.

Denial Management is probably one of the most difficult and frustrating parts of the revenue cycle. Often times it is thought that denial management begins once an Explanation of Benefits (EOB) is received with a payment amount of $0 and a denial reason. In actuality, denial management begins as soon as the patient schedules their consultation. Medical claims processing is a complex process. Our goal is to reduce the number of errors that cause your denials. We do this by identifying and correcting the most common causes.

MAXIMIZE REVENUE WITH BILLING PROFESSIONALS

Common Reasons for Unpaid Claims.

  • Incorrect patient demographic information

  • Provider coding contains errors

  • The patient’s insurance ID is entered incorrectly

  • The patient was not eligible for benefits at the time of service

  • Diagnosis code is inconsistent with the procedure code

  • Pre-authorization was required and not obtained

  • Inappropriate place of service

  • The service was not deemed medically necessary

  • Provider legacy numbers were omitted

  • Modifiers are inconsistent.

OUR GOAL? SIMPLE.

Our goal is to reduce the number of errors that cause your denials. We do this by identifying and correcting the most common causes.

WHAT CAN WE DO FOR YOU?
WE SPECIALIZE IN SOLUTIONS.

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