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Denial Management
 
Most health systems lose between 3% and 5% of net revenues as a result of payment denials from insurance companies. Hospitals experience denials and rejections on almost 25% of claims submitted. Claim denials directly impact the bottom line. But it doesn't have to be that way.

At RevenueXL. we believe that the key to successful implementation of denial-management program is information systems that collect the data and provide means to analyze the same. If you don't have the systems to gather and systematically analyze the data, you will never get your arms around this issue. Not being able to address denials in a systemic fashion is like leaving money on the table.

To ensure that 100% of all claims are paid correctly after the first claim submission we have developed a denial management solution that address the variety of rejections and denials issued by the payers and provides the different functional units within the organization the tools to identify and take corrective action before revenue on account of denials needs to be written off. By analyzing trends over time, providers can uncover problems, pinpoint their causes and reduce their denials.

Our Denial Management Solution includes 3 main components:

  • Data Capture
  • Denial Analysis & Reporting
  • Denial Process Redesign

   
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