How it works?

Physicians across the nation have been struggling to find a professional who can relieve them of their administrative chores so that they can face the challenges of providing quality healthcare. Most physicians would rather prefer a specialist taking care of the reimbursement process and maximize their revenue but they are tirelessly looking for the rest to manage their revenue cycle management.

Account Analysis and Denial Management

Regardless of the vigilance you demonstrate while medical billing – insurance verification, authorization, compliant coding and billing – denials have become part and parcel of Medical Billing Revenue Cycle Management. While a few denials may not have a second possibility of redeeming, most them are rectifiable and can be realized. But, the absence of an accurate EOB Analysis can render you resubmission and appeals for ineffective, resulting in substantial erosion of your revenues. As the cumulative effect of this revenue erosion may even have adverse impact on practices' sustenance and growth in the long-run. A proper and timely Account Analysis and Denial Management becomes very crucial.

While it is easy to identify the necessity of Account Analysis and Denial Management, it is quite harsh to expect medical practitioners to do it themselves as Account Analysis and Denial Management is primarily a specialist job. Therefore, it is inevitable to avail proven Medical Billing services that render such a thorough Denial Analysis and Management possible.

We, – having been a proven Medical Billing Consortium offering quality and result driven medical billing services to diverse medical disciplines – are known for effectively deciphering the reasons for denials, and augmenting resubmission and realization through instant Denial Analysis and Management Process.

To substantiate our Denial Analysis, we judiciously:

  • Figure out specific causes for the accumulation of the denied receivables. Such Denial Analysis provides us the characteristics of the denials, and to get them resolved comprehensively.
  • Analyze the financial impact of the Denials; our team of expert medical billing professionals is adept at identifying the general pattern and stake of the denials to evaluate its impact on financial returns.
  • Provide feedback to improve the efficiency Root-Cause Analysis and Financial Impact Analysis of Denials.

Having identified the root causes of denials, Denials are processed for corrective action: Resubmission and Realization. Usually the process follows:

  • Correction and Resubmission, wherein data is corrected and claim is re-submitted; in some complex cases, attaching supporting documents, inquiring client for additional information or clarification, and research is also done.
  • Effective Appeals, wherein standard appealing forms are put in place for the claims denied despite resubmission.
  • Timely Follow-up, which ensures that your Account Receivables are received within 25 days; our ingenious Resource planning ensure that all the unpaid claims are being followed up within pre-defined time frame.

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