Reduce Denials through Analytics
Denial management services are crucial for maintaining the financial health of healthcare organizations. Within the complex revenue cycle management process, claim denials present a significant challenge to cash flow and overall revenue. Effectively managing and resolving denied claims is essential for mitigating revenue losses. Our specialized denial management services provide a comprehensive approach, thoroughly examining claim issues to identify and resolve them, allowing healthcare organizations to recover lost revenue efficiently.
To ensure ongoing operational success, healthcare organizations must proactively address front-end processes to prevent future denials. HealthIQ Solutions, known for its robust methodologies and industry-best practices, offers a tailored approach to enhance revenue cycle management with a strong focus on denial management services. By exploring the root causes of each claim denial, we help strengthen your organization’s financial health with effective denial management strategies. Let us help you build a more resilient revenue cycle through proactive denial management services designed to meet your organization’s unique needs.
Denial Management Capabilities Include:
- Eligibility Validation
- Retro Authorization
- Provider Credentialing
- Aggressive A/R Follow-up
Service Highlights:
- Examination of denied claims for reasons with POA
- Resubmission of corrected claims
- Filing appeals with or without documentation
- Root Cause Analysis (RCA) to identify denial trends by payer
- Front-end claim corrections to minimize future denials
- Implementation of best practices to prevent future denials
Benefits:
- 25% reduction in AR days and 8% increase in collections
- Drive denial rates below 4% based on industry practices
- 24-48 hour quick turnaround time
- Success measurement through denial trending and AR reports
- Priority focus on fixing and preventing claim denials
- Dashboard reporting with denial analytics