Denial Management

Let us convert your every denied claim into dollars.

Consult with the best Denial Management Team

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Denial Management Services by iSolve RCM

Whatever the reason, most claims denials are a direct result of staff oversight. We at iSolve RCM are equipped with the best medical coding and billing professionals, hand-picked for their expertise in the domain. These professionals are perpetually enrolled in continual staff education initiatives, so as to possess the most up-to-date knowledge on the billing and coding guidelines.

Insurance companies usually have approved lists of diagnostic procedures or combinations they are willing to pay for. iSolve RCM maintains and updates a database of such combinations approved by different insurance companies. Our team will simplify work processes, Reduce costs & help you reduce regulatory risks.

Quick Justification

Effective tracking methodologies
Identifying the root cause for denials
Applying technology that is up-to-date
Pre-service, concurrent, and post-service reviews

Denial Management Workflow

Implementing the best practices and streamlining the Process

Proper denial management in medical billing can ensure the practice's financial stability in the long run. By efficiently managing claim denials, a practice can increase its collection rates and revenue while boosting patient satisfaction. Healthcare practices should consider these fundamentals for effective denial management:

  • Prevention

  • Analysis

  • Tracking

Prevention

Preventive actions can minimize denials. Implement these actions during pre-admission, registration, scheduling, and billing. However, denial management experts should oversee the progress and deliver information about the changes and the process from time to time.

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Analysis

When denials occur, analyze them to understand the cause and prevent them from reoccurring.

Tracking

Successful denial management in healthcare involves monitoring claim payment patterns and creating a system to pinpoint any deviation. It is crucial to determine the reasons for denials and enhance efficiency while reducing revenue losses.

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New Technologies

New technologies, tools, and software solutions are available to help healthcare practices oversee denials and take immediate action when they happen. Denial management in medical billing could implement an organized system for tracking denied claims. Another option is to outsource their revenue cycle management to specialists specializing in denial management in healthcare. That way, they can get a full suite of RCM management services that can boost the health of their revenue.

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