Minimize Denials with Expert Denial Management
No more claim denials, and you can accelerate your payments with our expert denial management services.
Accelerate Revenue Using Our Expert Denial Management Services
Managing denials is a crucial part of optimizing the revenue cycle. For this reason, every healthcare practice, whether it’s a small one or a big one, needs proper denial management. Otherwise, there will be serious issues such as revenue loss, delays in payments, and repetitive billing errors. Dealing with issues like these is a daily part of our team. iSolve RCM, the best medical billing company, has experienced specialists who determine the root causes of the denials and know how to handle them, and offer effective denial management services.
What is Denial Management in Healthcare?
It is a detailed process that includes identifying, assessing, correcting, and preventing denied claims from insurance companies. Reducing claim denials is the main goal of denial management in order to maximize revenue recovery. You can reduce denials by noticing the root causes of denials, such as coverage issues, incorrect documentation, and more. Healthcare providers can successfully lower administrative costs when they understand and address these problems.
From Claim Denial to Clean Claim: A Comprehensive Process of Denial Management
The following are the steps we follow at iSolve RCM to provide expert denial management:
Identity
It is the first step of the denial management process. You start this procedure when you receive the denial notice from the insurance company. At iSolve RCM, we have a team of experts who quickly identify errors in the medical billing system, which is the root cause of the denial.
Manage
In this step, the expert team analyzes the denial notice to identify the causes and patterns of denial codes to avoid issues by reducing denials. There are two types of denials:
Soft Denials: Denials that are reversible and correctable are called soft denials. They are caused by missing documentation or incorrect coding.
Hard denials: Denials that are irreversible and cannot be corrected are called hard denials. They are caused by non-covered services or exceeding coverage limits.
Monitor
In this step, our experts resolve denial issues quickly after finding it. Whether the issue is missing documentation, incorrect coding, or incomplete information, we can fix it all. After resolving the issues, we monitor the appeal and resubmission of claims. Our experts continuously review the resubmitted claim and keep in touch with the insurance company to ensure a smooth process.
Compliance Audit
Once all of these problems have been fixed, we send the updated claims to the insurance provider. Resubmission ensures that claims are processed with the right information to avoid rejections. The most important task of denial management is to avoid future denials. It avoids delays in payment and increases the trust of patients in your practice
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Common Denial Reasons in Medical Billing
Claims are most commonly rejected due to the following reasons:
Incorrect information
Incorrect information includes cases where the name of the patient, birth date, and insurance ID number are wrong. This inaccurate information makes it impossible for insurers to verify the identity of the patient.
Incorrect codings
Wrong codes, such as a diagnosis code (ICD-10) that doesn't accurately reflect the patient's condition, procedure codes like CPT/HCPCS that don't match the treatment or service performed, missing codes, and more, can lead to claim rejections.
Missing the deadline
When the healthcare providers fail to submit the claim within the specific time provided by the insurance company, the claim automatically gets denied. It can increase the burden on administrative staff and can result in lost revenue.
Lack of insurance coverage
When patients miss payments, fail to renew their insurance coverage, or receive non-covered services or treatments, the claims are denied. This puts a negative impact on patient care, leading to fewer treatment options.
Submitting the same claim multiple times
Submitting a lot of duplicate claims is the most common reason for denied claims. Insurance companies consider duplicate claims to be fraudulent and quickly reject them, causing delayed reimbursement.
Why Choose Us?
Choose iSolve RCM, one of the top medical billing companies, for affordable medical billing and consulting services that reduce denials and increase collections.
- 100% HIPAA-Compliant Medical Billing
- Boost Revenue
- Less than 1% Rejection
- 99% Acceptance
- No Hidden Fees
- Enhance reimbursement outcomes
- 24/7 Access
- As low as 2.99% of monthly collections
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Choose iSolve RCM’s Unmatched Denial Management Solutions for Better Financial Health
Check out our expert denial management services, which are perfect for your healthcare practice.
- iSolve RCM is the best medical billing company who adheres to all industry standards and regulatory guidelines, which protect your practice from costly mistakes.
- We provide a healthy revenue cycle through effective denial management, which improves the profitability of your medical practice.
- Our regular monitoring quickly identifies denials, so it gets corrected quickly, and it gets you money faster. Overall, this improves the revenue of a healthcare practice.
- We have highly skilled denial management specialists who are knowledgeable about complex denial codes and insurance policies to offer the best denial management services.
- At iSolve RCM, we quickly recover revenue because we care about your time and do not let you wait.
- We not only submit claims, but also try our best to avoid and minimize claim denials to reduce the administrative workload.
FAQ's
What is denial management in medical billing?
A process of managing and addressing denied claims by insurance companies that have been submitted by healthcare practices is called denial management in medical billing to ensure timely reimbursement.
How does iSolve RCM resolve claim denials?
At iSolve RCM, our experienced specialists follow the four steps: identify, manage, monitor, resubmission, and prevention, to resolve claims denials.
Why does the claim mostly get rejected?
Claims mostly get rejected due to the following reasons:
- Incorrect patient information
- Incorrect coding
- Missing the deadline
- Submitting the same claim multiple times
- Improper referrals, and more
Is iSolve RCM HIPAA-Compliant?
Absolutely! iSolve RCM is a HIPAA-compliant medical billing company. We follow all legal and regulatory standards related to patient data security and privacy.
In which medical billing specialties are you experienced with?
At iSolve RCM, our experienced medical billers and coders are highly skilled in 50+ specialties, which helps your cash flow and minimizes delayed payment.