Stop working in denial.
Even on the best of days, the last thing you want to deal with is a denied insurance claim. They’re costly, time-consuming and disrupt your revenue cycle. With our Denial Management solutions, you won’t have to worry any more. By identifying and eliminating the root causes of denied claims, we can help you significantly increase your cash collection and maximize reimbursement.
Unresolved claim denials lead to revenue leakage, impacting the financial health of healthcare providers.
Unresolved claims denials drag down your financial health, taking valuable revenue from services rendered out of your organization’s pocket.
Denials often result from incomplete or inaccurate documentation of patient information and services rendered.
More often than not, denials are a result of incomplete or inaccurate documentation of patient information and services rendered.
Manually resolving denials can be time-consuming and resource-intensive.
Denied claims must be resolved manually, a time-consuming and resource-intensive process that takes your team away from other, more pressing tasks.
Without clear insights into the reasons for denials, it’s challenging to implement effective prevention strategies.
Lacking any clear insights into the causes of denials can make it challenging to implement effective prevention strategies.
Denial Complexities Can Cost $265.6 Billion
Learn about the new process for measuring outcomes of denials management efforts, including key performance indicators (KPIs), established by the HFMA Claim Integrity Task Force.
Make denied claims a thing of the past.
Our Denial Management solutions are built using HFMA® Peer Reviewed software and deliver exceptional service in handling and appealing denied claims promptly and with precision.
Product Features
Denial Management
Our solution’s customizable three-step process delivers a tangible decrease in denied claims, allowing your staff to focus on the tasks that really matter.
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Accounts Receivable Days – 40 Days Accounts Receivable > 90 Days: 17% Denied Claims Upon First Submission: 4%.
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Time period flexible and include a shared risk model.
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1 in 4 acute hospitals across 50 states call TruBridge a partner.
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RCM software and service have been HFMA® Peer Reviewed.
Step 1: Analyze, Prioritize, Report
An electronic analysis of your 835 remittances and 837 claims data will yield valuable insights. We categorize and prioritize denials into key areas, including the number of claims and the corresponding revenue opportunity, plus report-inclusive data.
Products Used
Claims Management
Automates error identification, ensuring a 97% first-pass clean claim rate, and frees up staff for other projects.
Contract Management
Ensures accurate claims, streamlining reimbursement monitoring and validation for improved contract control, workload efficiency, and cash flow.
Revenue Cycle Assessment and Analysis
Delivers a swift, non-disruptive financial audit, revealing hidden issues and threats, along with a custom plan for immediate implementation.
Step 2: Onsite Assessment and Remediation
Through a detailed review of your current workflows from patient registration to claims submission, we’ll discover the root causes behind denied claims. Then, we’ll help you automate the process, implementing best practices and re-engineered workflows to avoid future denials.
Products Used
Claims Management
Automates error identification, ensuring a 97% first-pass clean claim rate, and frees up staff for other projects.
Contract Management
Ensures accurate claims, streamlining reimbursement monitoring and validation for improved contract control, workload efficiency, and cash flow.
Revenue Cycle Assessment and Analysis
Delivers a swift, non-disruptive financial audit, revealing hidden issues and threats, along with a custom plan for immediate implementation.
Step 3: Ongoing Monitoring and Tracking
Our continued monitoring will help keep things moving in the right direction, working with you to ensure the root causes of denials have been resolved while finetuning workflow modifications using trend reporting and data analytics where necessary.
Products Used
Claims Management
Automates error identification, ensuring a 97% first-pass clean claim rate, and frees up staff for other projects.
Contract Management
Ensures accurate claims, streamlining reimbursement monitoring and validation for improved contract control, workload efficiency, and cash flow.
Revenue Cycle Assessment and Analysis
Delivers a swift, non-disruptive financial audit, revealing hidden issues and threats, along with a custom plan for immediate implementation.
Let's Talk.