Denial management is all about figuring out why insurance claims get denied, fixing those issues, and preventing them from happening again. Our dedicated denial management team identifies, and addresses claim denials promptly, maximizing revenue collection.
Maximizing Revenue with Denial Management
Our dedicated denial management team identifies, and addresses claim denials promptly, maximizing revenue collection.
Denied claims are a major concern for revenue cycle leaders facing cost pressures and staffing challenges.Guhilot Health Denials Recovery helps healthcare organizations recover 15%+ cash from incorrectly denied or underpaid claims by commercial, government and managed care payers.
What Makes Our Process Better
Identifying Key Denial Reasons
We at Guhilot Healthcare understand the frequent and hidden reasons behind constant denials may require complete examination of your billing procedures and management. Once Identified we make sure to fix the issue for faster reduction in denials and effective claims management.
Categorizing the Denials
After identifying the denial volume and reasons, our next step is to categorize the denials so that they can be monitored and routed to the appropriate department for remediation. Sorting and analysing denials by category will help identify opportunities to revise processes, adjust workflows or re-educate employees, physicians and clinicians.
Establishing Tracking Mechanism
After categorizing the reasons for denial, we develop a tracking/reporting mechanism in which the following information can be easily ascertained -
- Top denial categories impacting the organization
- Top payers impacting the organization in terms of claims dollars denied
- Top departments/service areas impacted by denied claims
Monitoring and Preventing
Denial management program is an ongoing process that must be continually monitored and assessed to prevent repetitive revenue leakage. Our denial management team at Guhilot Healthcare helps to -
- Create a multidisciplinary team that can analyse denial information and as a group review trends, determine which categories to address first, and discuss their resolution.
- Schedule regular meetings with the multidisciplinary team in order to focus on a specific denial category.
- Continuously monitor the adequacy of these internal controls against their effectiveness in the management and prevention of denials.
