Denial Management

Denials can have an adverse effect on the cash flow. Managing denials promptly and effectively will result in an increase in the cash flow and enhance the effectiveness of the billing process with higher first-level passes.

Denials occur due to reasons like:

Inaccurate or Incomplete Insurance information.

No Pre-Authorization Code.

Errors and Omissions related to coding and charges.

Filing claims past the stipulated time.

Credentialing Errors or no enrollment of the provider.

The denial management team establishes a trend between individual payer codes and common denial reason codes. This trend tracking helps to reveal billing, registration and medical coding process weaknesses that are then corrected to reduce future denials, thus ensuring first submission acceptance of claims.