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Billers must do a root-cause investigation, take steps to address the identified flaws, and then file an appeal with the payer to successfully appeal refused claims. To survive, a healthcare company must constantly fix the front-end procedures issues to avoid repeat denials.
Denied or rejected claims slow down revenue collection and increase operational costs. Whether it’s a coding error, eligibility issue, or incomplete documentation, our experts perform in-depth analysis and corrective action to reduce denial rates, fast-track appeals, and streamline your entire billing process.
Along with boosting cash flow, we also assist in determining the core reason for any denial and putting in place preventative measures to avoid future denials.
Once the reason and cause of rejection have been identified, the claims must be separated and routed to the appropriate departments. Sorting denials by category will assist in identifying areas that need to be addressed and the need to re-educate employees and medical personnel to reduce denial rates.
Our specialists gather data on the patient’s insurance coverage and eligibility. This phase must be completed with zero margins for mistakes to avoid any errors, which might lead to denial in subsequent steps.
It’s critical to pinpoint the regions that lead to claim denials and the fundamental pattern that underpins them. This might entail a re-evaluation of the entire charging process. This method may identify the issue zone, resulting in fewer denials and a higher rate of successful claims.
Our automated multi-channel appointment system (via calls, emails, and live chat) reduces no-shows and keeps your schedule full—directly impacting your revenue consistency.
Using trend and category reports, we help you visualize denial trends over time. These insights drive continuous process improvements across your billing workflow.
Provide a single, on-demand view for all users to manage all elements of claim denials and re-submissions.
01
Manage the denials of all payers’ claims.
02
Reduce first denial rates to less than 4%, which is the industry standard.
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To assess the impact of process improvements, provide important trending reports.
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Ensure that all HIPAA technological security and privacy requirements are met.
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Provide high-quality services at a low cost with a short response time.
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Feature | Impact |
Denial Classification | Targeted resolution by denial type |
Eligibility Validation | Prevents denials from coverage issues |
Appeal Processing | Faster claim recovery |
Trend Analytics | Informs strategic decision-making |
HIPAA Compliance | Secure handling of patient data |
So ready to put an end to revenue leakage? CareMSO assists healthcare providers in mitigating billing errors and minimizing claim rejection, recoup reimbursements, and staying afloat. It provides quality, timely services offered by our expert denial management services. Become a part of the network of providers with CareMSO and optimize your revenue cycle and set your practice on a sustainable growth path with efficient, proactive billing.
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