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RCM Health Care

Denial Management

Effective denial management is an integral aspect for healthcare providers, independent physicians, and medical practices. Denial claims can significantly impact revenue by leading to unpaid or delayed payments. Failing to address denials appropriately can result in substantial revenue losses for your practice. Despite allocating considerable resources to establish an efficient revenue cycle management system, issues such as lack of transparency, administrative errors, inadequate claim follow-up, and unfair payments contribute to a significant amount of bad debt written off by healthcare providers.

Our Denial Management Services include:

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What makes PSPRO Solution’s healthcare denial management services world class?

PSPRO Solution‘s denial management services provide comprehensive visibility into each claim, allowing us to identify any errors that could potentially lead to denials. Our skilled denial management team conducts a thorough examination of your billing documentation and procedures. Their specialized training enables them to pinpoint areas that may contribute to denials, resulting in faster resolution and improved revenue inflow.

 

Our services follow a proven procedure to clear claims and streamline your financial processes. Understanding the reasons behind claim denials is crucial for maximizing revenue collection. PSPRO Solution‘s first step is to identify not only the denial itself but also the underlying reason. We then establish a tracking mechanism to enhance the organization and efficiency of handling denial-related information. Denial management is an ongoing process, requiring continuous monitoring and assessment to identify and address any issues. With PSPRO Solution‘s proactive approach, we diligently follow up on denials, utilizing our in-house automation system to expedite claim status inquiries and resolve denials promptly. This automated process ensures claim statuses are obtained up to ten times faster, facilitating quicker resolution of denials.

 

By partnering with PSPRO Solution for denial management, you can enhance revenue recovery, streamline your operations, and optimize your financial performance.

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Expert denial and appeal management teams

Our competent and experienced staff possesses the necessary expertise to draft written appeals and provide supporting documents based on medical records. They also verify earlier payment analyses conducted by the payer.

Sorting denials categorically

To address claim denials effectively, our team of experts categorizes denial data to identify opportunities for process improvement and employee training in healthcare practices. This sorting process enables efficient follow-up to promptly resolve denials. Healthcare claim denials can be complex, with various reasons for rejection. However, our highly trained and dedicated experts employ approved and successful processes to maximize payments, expedite claim settlements, and streamline denial management.

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Comprehensive reporting

Atlantic’s accurate reporting provides valuable insights and recommendations for better business decisions and prevents future denials. You gain significant understanding and suggestions for enhancing documentation and process improvements to increase clean claims.

Integrated data

Our stringent security protocols ensure the integration of data at a high level, preventing any data security breaches, and allowing real-time access to data for clients.

Improve financial performance

Atlantic’s software effectively classifies and categorizes denials, enabling analysis of the root causes. With this information, we develop customized process improvements to help you reduce denial rates and optimize revenues.

High-quality service

We offer top-quality denial management services at cost-effective rates, ensuring a quick turnaround time for your revenue cycle management.

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Adherence to industry regulations

Atlantic strictly adheres to industry regulatory protocols, ensuring compliance throughout the denial management process, including identification, documentation, appeal management, and follow-up. All our processes are HIPAA compliant.

Business Solutions

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