Denial Management Services

Improve clean-claims rate

Recoup revenue & maximize reimbursements

Expert assistance in handling Denial Management

It is an undeniable fact that claim denials continue to be a thorn in the flesh for many healthcare providers. It has been rightly said “If you can't measure it, you can't manage it”. This holds true for claims denials too. Without a strong denial management system in place dealing with claims denials can be frustrating and time consuming. Scribe4Me’s Denial Management service is designed to perform a root cause analysis and take necessary action to resolve it. But that’s not all. It also includes reducing the risk of future denials, ensuring that you get paid faster and enjoy a steady cash flow.

Scribe4Me has established a solid healthcare denial management system and this is how it works:

Identify

As a first step we undertake to identify the root cause and determine the reason for the denial. When the insurance provider denies a claim they indicate the reason referred to as Claim Adjustment Reason Codes (CARC). Unfortunately, interpreting these codes takes time and requires expertise, since some insurance providers continue to use the overly complex, legacy codes. But our dedicated denial management professionals can easily handle these codes and identify why a claim was denied and who is responsible for its reimbursement.

Manage

Once the reason has been identified we take the steps necessary to resolve it. For this purpose we route the claims directly to the concerned department for them to quickly and efficiently act on each item. Our team follows a streamlined approach to sort and analyze denials by amount, time, reason, among other factors. This helps us to identify the categories that have the greatest denials and restructure processes and implement quality control measures to stop denials at its tracks. Once the reasons for denials have been categorized we assign it to the respective team to take corrective action.

Resubmit

Most of the claims denied are recoverable. All it takes is to rework the claim, ensure it is correct, and resubmit it. So, once the reasons for denials have been identified and categorized, we resubmit the claim. After making the necessary corrections and addressing the issues that led to the denial in the first place, claims are resubmitted for payment without any further delay. As the odds of reversing a denial are good, this is a crucial step to increasing revenue rather than losing money that may be rightly owed to your practice.

Monitor

We believe that denial management is an on-going process that needs to be continually monitored to keep track of everything and ensure that claims get successfully paid this time around. For this purpose we keep track of denials by type of denial, date received, date appealed, and resolution. Then we audit the denial management team’s work by selecting a sample of their appeals and finally make sure that they are equipped with the tools and technology to get their job done.

Prevent

With all the relevant data regarding denials in hand we setup a prevention campaign. We look for opportunities, to revise existing processes, modify existing workflows or retrain our staff. Together with it, we also

  • Set up a multidisciplinary team to analyze denial reasons, study trends and discuss which categories to address first
  • Set up regular meetings with the multidisciplinary team to focus on a particular denial category
  • Follow-up on the effectiveness and adequacy of the internal controls in managing and preventing healthcare denials

Our Service Highlights

  • HIPAA compliant tools and technologies to track and follow-up on submitted claims
  • Team with extensive knowledge of payer-specific guidelines
  • Denied claims analyzed for reasons with power of appeal
  • Root cause analysis of denial trends by payers
  • Tackle claims denial causes from the front end to reduce denials
  • Proactively prevent future denials with our best practices

Benefits of Scribe4Me’s Denial Management Services

  • Improved clean claim rates
  • Strict adherence to HIPAA regulations and their compliance
  • Denial management experts hand-picked for their expertise and experience in the domain
  • Regular training for the team to sharpen their skills and keep them updated with the latest payer-specific guidelines
  • Keep the initial denial rate below 4% (industry average is 5% to 10%)
  • High-quality services at cost-effective rates
  • Fast turnaround times
  • 40% reduction in operating costs
  • State-of-the-art infrastructure, cutting-edge tools, and technologies that are at par or above industry standards

Outsource Denial Management Services to Scribe4Me

As your trusted denial management partner Scribe4Me aims to reduce denial rates over time and help your practice thrive. With Scribe4Me you gain access to a large pool of denial management specialists who have experience in dealing with a wide range of denial scenarios and can leverage their expertise to resolve issues quickly. We help identify the root cause, prevent future denials, get paid faster and enjoy a healthy cash flow. Uncover strategies for successful denial management with Scribe4Me - Enhance your financial stability and improve operational efficiency. Sounds appealing? To learn more about our denial management services and how our team at Scribe4Me can boost your revenue cycle and financial success get in touch with us today.

Revenue Cycle Management

Are you a healthcare provider under increased pressure to focus on providing care as well as maintaining financial viability? Do you feel overwhelmed with administrative and financial responsibilities? Feel like you are losing pace on follow-ups for efficient collection? Are you short of trained experts to handle the complex maze of RCM? Scribe4Me is here to help you.


Insurance Eligibility Verification

Are you struggling with the time-consuming tasks of verifying and validating a patient’s insurance coverage eligibility? Thinking of taking the help of an insurance expert to relieve you from the tedious tasks of verifying insurance coverage? Then the best option is to outsource your Insurance Eligibility Verification services to an experienced service provider like Scribe4Me.


Medical Coding

Do you find it challenging to keep pace with the yearly updates to code sets and changing payer regulations? Are you facing coding errors that cause delays in reimbursements? Are you short of highly trained certified medical coders with experience across multiple specialties? If yes, outsourcing your medical coding services to Scribe4Me is your best bet.


Charge Entry Services

Are charge entry tasks consuming much of your front office personnel’s time? Is claim denial slowing things down and delays your payments? Do you feel there isn’t any collaboration between your charge entry and coding team? If yes, you’ve come to the right place. Outsourcing your Charge Entry services to Scribe4Me ensures error-free and accurate entries for cleaner claim submissions


Claims Transmission

Is your medical practice struggling with the time-consuming and labor intensive process of claims submission? Are you finding it difficult to keep pace with regulatory demands? Do you lack skilled resources to handle your claims submissions effectively? Opting for Scribe4Me’s Claims Transmission services is the best thing you can do to achieve greater accuracy in claims settlement and reduction in costs.


Payment Posting

Do you find the payment posting process time-consuming and tedious? Is your practice facing issues with rejected claims and late payments? Are you short of skilled resources to handle the important aspects of payment posting? Do you lack time amidst your workload and hectic schedule to manage these tasks? It’s time you take help from the experts in the industry.


Accounts Receivable Management

Do you feel that receiving payments on time is quite challenging? Do you lack the time and resources to manage the cost of debt over time? Are you on the lookout for an efficient system to manage your accounts receivables? Are aging accounts receivables piling up? If that is the case, you need a trusted partner like Scribe4Me to improve cash flow by enhancing your accounts receivables.

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