Denial Management

Claim denial by insurance payers is one of the biggest concerns for any healthcare providers. Denial Management process includes discovering and resolving the issues that are leading to denials and shorten the accounts receivables cycle.

Analyse the reason for rejection

Correct any errors specified

Get more details from patient if required

Re-submit the documents

Our key focus is reducing denials!

This can be dauting task and therefore, we employ highly specialized and experienced team of medical billers to handle denial management.

Our denial management team records, analyses and categorizes the reasons for denial.

The team draws patterns and reasons which may be specific to conditions or practice. This may need a complete examination of your billing procedures and management. This helps in creating a ready reckoner to prevent future issues so that in future we know exactly where to start fixing for faster reduction in denials and effective claims management.

Process

Whenever there is a denial or partial or outstanding payment, the medical biller will reach out to the respective insurance company in order to resolve and follow up on the claim. They will also understand the reason for rejection and try to fix the same for re-submission. Normally when the claims are rejected, the payer sends a status code as well as the reason for the rejection. The reasons can include, incorrect patient information, invalid medical code, lack of documents, clubbed or not-covered conditions among others. Calls are made to patients to obtain missing demographics, insurance information, and also discuss outstanding patient dues.

Get in Touch

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