Denial management

Denial management

Denial management services serve as an indispensable pillar in upholding the financial vitality of healthcare organizations. Across the intricate landscape of the revenue cycle management process, claim denials emerge from multifaceted processes, presenting a critical hurdle to cash flow and overall revenue health. Managing and rectifying denied claims stand as imperative concerns for healthcare entities, aiming to mitigate revenue losses. Our specialized denial management services offer a comprehensive approach, delving deep into the complexities of claim issues. This process not only identifies but also presents an invaluable opportunity for resolution, enabling healthcare organizations to recover lost revenue efficiently.

For sustained operational success, it’s paramount for healthcare organizations to proactively address front-end process intricacies, thus averting potential denials in the future. SpyHealth RCM, renowned for its robust methodologies and industry-best practices, extends a tailored approach to bolster revenue cycle management, emphasizing our expertise in denial management services. Explore the underlying causes behind every claim denial and fortify your organization’s financial health by leveraging SpyHealth RCM’s wealth of experience in crafting effective denial management strategies. Let us guide you toward a more resilient revenue cycle through proactive denial management services tailored to meet your organization’s unique needs.

Service Highlights
  • Denied claims examined for reasons with POA
  • Resubmission of corrected claims
  • File appeals with/without documentation
  • RCA done to trend denials by payer, etc
  • Front-end claim corrections to reduce denials
  • Prevent future denials with our best practices
Benefits
  • 25% reduction in AR days/ 8% higher collections
  • Drive denial rates below 4% industry practices
  • 24- 48 hrs. quick turnaround time
  • Measure success via denial trending/ AR reports
  • Fixing and preventing claim denials is our priority
  • Dashboard reporting – Denial analytics