Denial Management
Effective Denial Management can significantly boost revenue for healthcare providers. Given the complexity and dynamic nature of healthcare billing, investing in our dedicated denial management team is a wise and prudent choice for many healthcare organizations.
Turning Denials into Dollars with Our Proven Denial Management Process
Our Denial Management Process Steps
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STEP 1: IDENTIFICATION OF CLAIMS
To streamline the process, we capture and segregate claims based on their status - whether they have been denied or rejected by the insurance companies or approved.
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STEP 2: CATEGORIZATION AND CLASSIFICATION
Our claims are meticulously categorized, ensuring a comprehensive understanding of denial reasons. Common causes for denials encompass coding errors, missing or incorrect customer information, issues with client eligibility, and insufficient documentation.
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STEP 3: ROOT CAUSE ANALYSIS
Our process involves conducting a thorough examination of the factors leading to denial. This helps us understand the root causes and implement preventive measures to minimize future denials.
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STEP 4: CORRECTION AND RESUBMISSION
After identifying and understanding the denial reason, necessary corrections are made to the claim, such as fixing coding errors, updating healthcare customer info, or adding required documentation. The corrected claim is then resubmitted for reevaluation.
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STEP 5: TRACKING AND FOLLOW UP
We track the progress of resubmitted claims with regular follow-ups to ensure timely payment.
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STEP 6: APPEALS PROCESS
To begin an appeals process, we gather supporting documentation and formally request the insurance company to reconsider a denied claim.
Our End-to-End Denial Management Services
Our holistic solution led by denial specialists maximizes revenue, improves efficiency, and allows healthcare providers to focus on quality healthcare client care.
Our expertise in denial management benefits clients by streamlining the complexities, facilitating fair and timely compensation. This improves financial health and allows a primary focus on delivering healthcare services.
An efficient denial management process identifies and rectifies systemic issues, reducing the risk of repeated mistakes. This brings significant advantages, including minimizing associated financial implications.
Build your outsourced clinical denial management team to cut down in-house costs and improve revenue.
Why Choose Our Denial Management Services
Revenue Recovery
Operational Efficiency
Risk Reduction
Cash Flow Stability
Improved Healthcare Customer Satisfaction
Transparency And Accountability
DME Service Solutions - A Leading Denial Management Company in the Healthcare Industry
+347%
Maintained support for Increase in call volume
-41%
Decrease in average days to collect documents
~15
+166%
Increase CGM Orders YOY Q1-22 vs Q1-23
94%
Consistent service level results
-17%
Decrease in avg handling time