Key Functions of Denial Management

• Maximize cash flow - Reporting identifies denial causes having the greatest financial impact, thereby accelerating cash flow.

• Identify the root cause of denials - Collecting and interpreting denial patterns to quantify denial causes and their financial impact.

• Support accurate workflow priorities and scheduling for follow up - Collecting information on denial appeals, including status, escalation, correspondence with payers, and the disposition of denial appeals to increase recovery amounts.

• Provide accurate and timely statistics for Management / Clients - Providing management analysis reports and other information to prevent future denials.

• Track, Prioritize & Appeal denials - Generating appeal letters based on federal and state statutes and case citations favoring the medical provider's appeal.

• Avoid out-of-timely filing.

• Analyze the effectiveness of denial resolutions.

• Identify business process improvements to avoid future denials

Posted in: denial management