Most Common problem faced by healthcare providers and medical Billing companies is that large numbers of rejected claims are goes unattended and thus never resubmitted. Our Urcare Team just does not resubmit a claim in Denial Management, but it analyzes the reason for denial, track the common factors and work accordingly on identifying and eliminating weak links. A lot of data is required to achieve powerful results from denial management. Our team process reports and measures all claims that are being denied by your payers. With this level of data, our specialists fix all kinds of issues which lead to the denials (whether it is issues with the claims or issues with the payers). Once we do this, revenues for your practice will increase by 10 to 20 percent.
Our Skilled Team always follows below three key fundamentals to manage denials from payers and provide the best solution.
Prevention or Information Verification before claims are sent out:
As the most common reason for denials is incorrect information: ID numbers maybe incorrect, names may be spelled incorrectly, or don’t match what is printed on the patient’s insurance card. Thus our team focuses on actions that can be taken upstream in the patient encounter to prevent denials from occurring in the first place. Our experts make sure that we track such trends and keep the Client informed periodically about improvements/process changes that can be made across functions.
Focus on Reasons of Denials:
Urcare ensure that the regulations around billing are being done correctly in the first place. Usually stricter Medicare and Medicaid regulations, and the need for frequent- authorizations for payment increases denial rates if not proactively managed. So Process of analyzing and aggregating similar denials is strategic in denial management. Urcare identifies such denials and make sure that it decreases future denials.
Tracking and Trend Management:
Depending on the denial reason, we go forward and resubmit claims even before you get denial paper through the mail. We call the insurance company and find out the denial reasons instead of waiting to receive the denial in the mail, we than correct the reason the claim was denied for. Besides keeping a track of the denial trend from payers our expert’s team also actively monitors the payment patterns from various payers and set-up a mechanism to alert when any deviation from the normal trend is seen. This is important in understanding the causes of claim denials and enhancing long-term efficiency and drastically reducing lost revenue.