Denial Management Services for Hospitals and Healthcare Providers

TruBridge helps hospitals and clinics reduce claim denials, recover lost revenue, and streamline denial resolution with expert RCM denial management strategies and HFMA-backed solutions.

Comprehensive Denial Management Solutions to Stop Revenue Leakage

Healthcare denial management is one of the most critical challenges facing hospitals and clinics today. Denied claims drain revenue, burden staff, and disrupt cash flow.

TruBridge denial management services help healthcare providers identify and eliminate the root causes of denied claims, increasing cash collection and preventing recurring denials.

Challenges: Why Denied Claims Impact Your Hospital

Revenue Leakage from Claim Denials

Revenue Leakage from Claim Denials

Unresolved claim denials reduce cash flow and undermine financial stability. TruBridge identifies and resolves the root causes of denied claims, recovering revenue efficiently.

Documentation Errors Cause Denials

Documentation Errors Cause Denials

Incomplete or inaccurate documentation is a leading cause of rejected claims. TruBridge validates coding and documentation before submission, reducing denials from the outset.

Manual Denial Resolution Drains Resources

Manual Denial Resolution Drains Resources

Manually tracking and appealing denied claims consumes staff time and pulls teams away from patient care. TruBridge automates workflows to free your team for higher-priority tasks.

Analytics Insights Empower Prevention

Analytics Insights Empower Prevention

Without insights into denial patterns, hospitals struggle to prevent recurring issues. Our analytics tools identify trends and enable proactive strategies to reduce future denials.

Product Features

TruBridge Denial Management Solutions

TruBridge combines expert teams, advanced technology, and HFMA best practices to optimize denial management across hospitals and clinics.

• Accounts Receivable Optimization: Reduce AR days and improve cash flow with proven denial management strategies.

• Claims Denial Prevention: Analytics-driven insights and automated workflows prevent recurring denials before they impact revenue.

• Medical Coding & Documentation Checks: Ensure claims are accurate for first-pass approval with comprehensive medical coding denial management.

• Flexible Outsourcing Models: Shared risk and customizable services tailored to your organization’s unique needs.

• HFMA Peer-Reviewed Strategies: Proven best practices for denial management in healthcare, trusted by acute care hospitals nationwide.

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Product Features

How TruBridge Denial Management Works

Our proven four-step approach to claims denial management delivers measurable results:

1. Identify Denials and Root Causes Detect denial patterns using advanced analytics and denial management software to understand where revenue is being lost.

2. Validate Claims Before SubmissionVerify medical coding, documentation accuracy, and payer requirements to prevent denials and improve first-pass approval rates.

3. Resolve Denials and Manage AppealsHandle claim resubmissions and appeals efficiently, freeing your staff to focus on patient care.

4. Prevent Future Denials:Implement automated workflows and continuous monitoring for long-term denial prevention success.

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The old RMC playbook is broken - quick fixes and automation alone can't keep pace.

HealthLeaders data: a smarter blend of tech & expert partners is mandatory.  See how hospital execs are rethinking revenue cycle strategies to improve financial stability.

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peer reviewed crest by HFMA

TruBridge Denial Management Solutions: HFMA Peer-Reviewed Excellence

TruBridge Denial Management solutions are built upon the best practices and insights from the Healthcare Financial Management Association (HFMA). By leveraging HFMA-backed strategies, we help healthcare providers streamline workflows, reduce denial-related revenue loss, and improve overall efficiency, driving a healthier revenue cycle.

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Denial Complexities Cost $265.6 Billion: Discover the Solution

Learn how the HFMA Claim Integrity Task Force’s new process for measuring denials management can help reduce costs and improve efficiency. This case study explores KPIs and process improvements to streamline your revenue cycle.

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.

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.

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.

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Let's Talk.

Denied claims don't have to happen. Discover the solution you need with TruBridge.

Frequently Asked Questions About Denial Management Services & Solutions

  • Denial management in healthcare is the process of identifying, analyzing, and resolving rejected insurance claims to ensure accurate payments and improve the revenue cycle for hospitals and clinics.

  • TruBridge reduces claim denials, accelerates reimbursements, and manages appeals efficiently. Our experts handle the entire denial process, freeing your staff to focus on patient care.

  • TruBridge manages medical claims across hospitals, clinics, and outpatient facilities, including insurance verification, coding review, and patient billing. We ensure claims are accurate before submission to prevent costly denials.

  • Yes, outsourcing denial management to TruBridge allows healthcare providers to streamline operations, reduce administrative burden, and improve cash flow without hiring additional in-house staff.