Denial management

Our Urgent Care billing team is composed of certified billing experts that can boost the productivity of Urgent Care practices so that medical facilities can easily achieve sustainable financial growth and improve their cash flow.

The big worry of denial

When you will ask a medical practitioner about the biggest roadblock in the revenue cycle then the first name that you will hear is denial. Denials have become a part of the overall revenue cycle and it has penetrated the revenue cycle in such a way that around 25–30 percent of the overall expense of the medical facilities is a result of inefficiencies and direct transaction costs that are related to claim management. This is one of those parts of medical practice that no facility should ignore.

Because of such issues, there is a need for a better denial management approach so that it can be turned into an effective and cost-saving part of the medical facility.

Trust the best when it comes to denial management

We at Medphine have a team of certified, seasoned, and experienced billing experts along with highly skilled coders who will help you in improving the current claims denial management environment in your medical facility and improve your revenue cycle

At Medphine, we understand the importance of claims denial management in medical facilities and that’s why we have partnered with the best technology solution providers and analytics. Our heavy investment in both technology and analytics allows us to offer world-class denial management service to our clients and this is what sets us apart from the rest of the billing experts.

By taking advantage of advanced technology and analytics, we are able to keep tabs on the important KPIs that help in boosting the overall processing of denials. In addition to this, you will never have to burn a hole in your pocket for choosing our denial management service.

Changing the mindset through our approach

We have been providing billing services from a very long period of time and throughout our journey, we have come across many medical facilities that are not interested in appealing denied claims. Most of these medical facilities believe that they will not be able to recover enough from appeals and they will have to bear the expense of denial management administration.

But with our unique approach and unparalleled denial management service, we have been able to push medical facilities to change their mindset. You should know that more than 90 percent of the claims that were audited and passed by our team were reimbursed by the payer and this number alone is enough to speak about our success rate.

We use a proactive approach in order to restore all the stalled denial management processes and this helps the medical facility to improve the overall cash flow while keeping the revenue cycle stable and effective.

What’s so unique about our denial management approach?

  • Our team leverages DenialAnalyzer, which is one of the most advanced reporting and denial management apps in the market.
  • We never miss to categorize all the claims that we receive into a wide array of follow-up groupings and this makes us more effective with our denial management approach.
  • All the denials that we receive are first sent to the denial analysis department and then all the denials are categorized under two groups; full denials and line items.
  • We have partnered with both commercial and federal players and this is why we have a stronghold of how their payment structure functions.
  • All the redundant processes involved in the denial management processes are automated and this is how we are able to achieve the speed that our clients miss in in-house denial management.

Our 24/7 eClinicalWorks RCM Process

Appointment
Scheduling

Patient
Eligibility

Medical
Coding

Claims
Information

Claims
Creation

Claims
Scrubbing

AR
Calling

Denial
Management

EOB
Posting

Clearing
House

Claims
Transmission

Claims
Transmission

Clearing
House

EOB
Posting

Denial
Management

AR
Calling