With seasoned denial management professionals, Clarus RCM ensures that you can refile claims promptly and minimize lost reimbursements. Not only do we address your denial backlog, but also take steps to document the reasons for the occurrence of the denial and address it at the source, to iteratively reduce denials.
Components of Our Denial Management Services
Claims Resubmission. Each denied claim is analyzed, the issues with the claim are resolved, and the claim is resubmitted and followed up on regularly. We refile the claim with the correct ICD/CPT Codes, provide any supporting clinical documentation that is recovered, understand covered and non-covered services, and correct patient or insurance information.
Denial Prevention. We shift focus to denial prevention by aggregating denial reasons, perform analytics on top reasons and structurally address this with the revenue cycle team, and/or the clinicians. Educating the participants in the process chain is critical to denial prevention.
Correspondence and Appeals. We check the payer website for appeal formats, prepare the appeal letters and attach any clinical documentation that is required by the payer to reprocess the denied claims. The documentation is then faxed to the payers and periodically followed upon.
Benefits of our Denial Management Services
Our focus on account resolution through analytics, diligent appeals filing, claims resubmission, and follow-up processes bring the following benefits for our customers.
A dedicated team of denial management professionals focused on resolving claims
Structured analytics to reduce and prevent denials over time
A/R management dashboards that provide a clear view of the state of your revenue cycle
Develop exhaustive policies and procedures for write-offs and adjustments
Daily account support calls to address any issues
Reduce costs by as much as 50% through offshore delivery
Connect with Us
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