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, maximize reimbursement, and improve overall revenue cycle efficiency.
Revenue Leakage from Claim Denials
Unresolved claim denials lead to significant revenue leakage, undermining the financial health of healthcare providers. Address this challenge with solutions designed to prevent and resolve denials efficiently.
Documentation Errors Cause Denials
Incomplete or inaccurate documentation is a leading cause of claim denials. Our advanced documentation validation tools ensure claims are accurate, reducing denial rates from the outset.
Manual Denial Resolution Drains Resources
Manually resolving denied claims consumes valuable time and resources, pulling your team away from core priorities. Our automated workflows simplify denial resolution, allowing your staff to focus on strategic tasks.
Analytics Insights Empower Prevention
Lack of insight into denial causes can hinder prevention efforts. Our analytics tools provide actionable insights into root causes, enabling effective denial prevention strategies and continuous process improvement.
Streamline Denial Management with HFMA Peer Reviewed Solutions
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.
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.
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.