Denial Management
In Healthcare Practices
The claims rejection management process aims to identify the issues with the claim and provides a chance to correct them. Many people often mistake Denial Management for Rejection Management. Rejected claims are those that contain errors and have not been processed by the payer's adjudication system. The biller must correct and resubmit these claims. In contrast, denied claims are claims that the payer has adjudicated and denied payment. Healthcare organizations should prioritize both rejected and denied claims.
To prevent future denials, healthcare organizations must
continuously address front-end process issues
To successfully appeal denied claims, billers must identify and correct root causes before filing an appeal with the payer. We prepare appeal letters by analyzing denial reasons, attaching clinical documentation, and submitting the claims for an effective outcome and prompt reimbursements
Types Of Claim Denials
Soft denials :
Soft denials are temporary and need no appeal. They can be paid if your healthcare practice resolves the issue.
Hard denial:
A hard denial is a type of rejection that leads to lost revenue and necessitates an appeal.
Preventable denial:
A preventable denial is a hard rejection that results from avoidable issues, such as improper coding.
Administrative denial:
An administrative denial is a refusal in which the payer informs your organization of the reason for the claim's rejection.
Benefits Of Outsourcing
Denial Management To Us
Focus on getting claims resolved
Our priority is to resolve the claims rather than just obtaining information on their status.
Process Automation
We streamline the whole denial management process with modern technological integration.
Workflow automation
This helps us to offer the best customer service and diminish all the inaccuracies related to denial management.
Minimal Outstanding Account Receivables
Our clients experience a significant reduction in outstanding account receivables within a shorter timeframe.
We Are Here For You
Frequently Asked Questions
What procedure do you follow for denial management services?
Why is it important to manage claim denials and rejections?
Where can I find pricing plans and packages?