Medical Claims Denial Management Service

Whether you are performing medical claims denial management internally, or are dissatisfied with your current outsourced vendor, we can help. Our approach is organized, collaborative, communicative, and consistent. Our service lines include facility, physician, and specialty denial management. The work is performed by on-shore revenue cycle professionals that are experienced with payer requirements, regulatory and payer guidelines, insurance contracts, fee schedules, and coding edits and denials. We establish a relationship with your staff to streamline communication and ensure your policies and procedures are followed. We offer competitive pricing and rate structures that include hourly, fixed, and contingency models. We can implement it quickly and provide immediate results. Call us today for a complimentary consultation!

Denials Management Service Overview

  • Dedicated CRCR certified staff and Account Manager assigned to the project
  • Appeal specialists for technical and clinical denials
  • Specialists in Medicare, Medicaid, Workmen’s Comp, government, and other commercial insurance payers
  • Identify trends and provide remediation and recommendations for denial prevention
  • Analytic trending utilizing denial management software tools
  • Appeal submission including technical and clinical appeals
  • Ongoing communication and reporting
    • Denial tracking
    • Root Cause
    • Trends
  • Work is completed in the client host system
  • Alignment with hospital/physician KPIs and expectations
  • Internal and clinical coding review for edits/denials

No-Obligation Consultation

If you’re in the healthcare industry, we’d love to discuss how our unique solutions can help solve your revenue challenges. Contact us for a complimentary, no-obligation consultation. Call 480-688-0584.