Denial Management

• We identify and segregate full denials and line-item denials
• All denied claims are routed to the denial analysis department
• The claims are classified into different follow-up groupings, based on payer/denial type/value of claim/remark code
• Daily denial lists are created and assigned to specialized variance teams, who have in-depth knowledge of denial codes
• We follow specific payer guidelines for submission of appeals
• Claims with errors or missing information are corrected and resubmitted within 2 working days
• Our follow-up team communicate with insurers to retrieve lost revenue
• All pending denials stay on work lists (views) till they’re resolved

What you don’t know can hurt you! Knowing the cause of denials will increase long-term efficiency and minimize denials. Our denial auditing teams analyze denial information and organize claims into error categories, such as, incorrect NPI, invalid health insurance claim number, incorrect place of service, or claims denied due to eligibility, coding, authorization issues etc.,

Our auditors track denial patterns and frequency. We drill-down on the data gathered and go the extra mile to eradicate claim denials. We drive denial rates below industry standards.