An overwhelming amount of time, money, and resources are spent by healthcare organizations to appeal denials. To understand the magnitude, look at these staggering numbers:
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Of a total of $3 Trillion in healthcare claims, $262 Billion are denied.
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With the amount of time addressing these denials takes, as many as 65% of these denied are never resubmitted
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Denied claims can make a significant dent on an organization’s financial viability, and ineffective AR management is the #1 reason for the closure of a healthcare organization.
As revenue cycle administrators are caught in this vicious phase of managing denials, the resources that a denial prevention program seems like an additional burden on them. Contrary to this perception, denial prevention programs give you long-term and sustainable results and help you identify the root cause in each of the revenue cycle processes – Scheduling, patient registration, data capture quality, clinical documentation and coding, claims filing, and accounts receivable management.
Medical Billing Wholesalers’ Denial Management Services
Explore Medical Billing Wholesalers’ Claim denial management and Coding denial management services. We correct invalid or incorrect medical codes, provide supporting clinical documentation, appeal any prior authorization denials, understand any genuine denial cases to pass the responsibility to patients, and follow-up effectively. For addressing coding-related claim denials, we utilize certified coders with experience in the specific specialty. With their experience and expertise, they can narrow down on the issues, apply the right medical codes – using the right modifiers as per AMA guidelines, and apply CCI (Correct Coding Initiative) edits.
Improve reimbursements and reduce coding denial management with Medical Billing Wholesalers’ expertise and experience.
