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