Reducing Your Denial Claims and Optimizing Your Revenue Cycle

Centre State Practice Management possesses approximately 10 years of experience in assisting large healthcare providers as well as independent practitioners with their denial management requirements. Taking this experience, our experts have devised a well organized system which enables us to investigate through your entire data and identify the root causes leading to all the denials. Once we have managed to identify the problem, we develop a comprehensive report highlighting the current, upcoming as well as the persistent reasons for denials and from there on employ our processed enhancements to eradicate any denial claims hence improving and optimizing your revenue flow.

Our Enhanced Denial Management System:

  • Obtain prior authorization and gather every piece of information that we can regarding the patients health insurance coverage.
  • Assist our associates to recognize and identify the main causes of denied claims by insurance suppliers.
  • We categorize your denials by foundation, cause, division and other such factors establishing a simplified yet highly efficient denial management process.
  • We employ sophisticated and modern denial management policies that appoint patients and healthcare practitioners to successfully ask for unconfirmed denials and overturn them.
  • We have precisely evaluated our well developed denial management strategies to ensure that they are entirely effective and efficient.
  • We ensure to provide our users with the most advanced and current information regarding different windows that a variety of third-party payers require to file insurance claims so as to prevent any upcoming denials.

Here's How Our All-inclusive Denial Management Process Works

1

Recognizing Root-Causes of Denials

Recognizing Root-Causes of Denials

Our service starts with identifying the basic reasons causing denial of claims

2

Sorting Denials

Sorting Denials

Categorizing the denials helps us to track their department of origin and from there on we employ effective remediation measures

3

Developing a Tracking Process

Developing a Tracking Process

Once the causes of denials have been sorted, we go on to establish a systematic tracking and reporting mechanism

5

Monitoring and Preventing Denials

Monitoring and Preventing Denials

Finally, we ensure to develop a system that monitors all your claims and prevents any new or recurring denials

Our Specialized Denial Management Services

Deducing Denial Patterns

Here our experts have devised a well planned sorting system in which we categorize the denied claims to identify the specific categories giving rise to maximum denials and then we restructure and revise the existing processes to prevent any forthcoming arousal of denied claims at their initial roots. We also put quality assurance in place by carrying out frequent audits for these various categories which ensures the prevention of denials at their origin.

Data Collection for Denial Pleas

Our experts assist you in assembling all the information that you need regarding denial appeals to understand where the melancholy lies. Not only this, but we also ensure to help you gather information on the status of the appeals process. All the correspondence and interaction with the payers is also communicated to you for your better understanding on determining the results of denial appeals process. We also create the nature of the appeals to help you reorganize the recovery process and ensure the complete recovery of the amount.

Inclusive Coverage

Our denial management professionals provide precise reports to top management on the basis of which they take improved business decisions and avert any potential denials. We also grant claims processing reports containing a list of refusals that require to be resolved before claims can be further submitted to commercial insurance companies or government payers. Our efficient and updated denial management process discovers the main causes of denied claims that put a significant burden on your financial performance, thus accelerating your incoming revenues.

Following and Claiming Denials

We assist you in creating appeal letters based on state and federal decree to help in getting fully refunded for former denials and also track, and appeal denials with case records that support the medical provider’s appeals. After we have received a denied claim, we make sure that the appeals are filed within a week so that there is no interval time or delay in getting reimbursed. Our progressive tracking system logs claims as they go in and out of the appeals system so we are always conscious regarding the status of the claims appeal.

Systematic Categorization of Denials

We carry out a systematic categorization of denials in medical billing to determine prospects that regulate workflows, amend existing processes, and re-train healthcare providers. This helps us to track the department from which the maximum amount of denials originate and from there on we employ effective remediation measures such as carrying out audits and putting quality assurance in place, to prevent denial arousal from its source.

Recognizing Business Process Developments

Routing and mapping categories with the sum total of denials helps us prevent their arousal. Sorting out each category and deeply analyzing it enables us to identify the units from where the denials are actually stemming from and once we have recognized the major issue we make sure to come up with diverse business process improvements to resolve the problem at the source. This is what puts us among the best denial management companies in USA.

Here's What Distinguishes Our Denial Management Services

1

Complete Compliance

Complete Compliance

We conform to the unyielding documented protocols to ensure our compliance with HIPPA.

2

Strict Data Encryption

Strict Data Encryption

We believe in the complete privacy of our user’s information and for this purpose we use all types of encryption techniques such as VPNs, firewalls etc during communication for data security assurance.

2

Extensive Training

Extensive Training

Our staff is regularly trained so as to keep them updated and well versed with the upcoming knowledge.

3

Rapid Audits for Claims

Rapid Audits for Claims

We frequently carry out thorough audits of insurance etiquettes to identify the arising errors and preventing their arousal thereafter to streamline our insurance verification process.

5

Soaring Precision

Soaring Precision

Our experts ensure to supply our clients with a highly accurate analysis of insurance and billing verification which assists them in taking measures necessary for the reimbursement of their payments.

5

Sophisticated Technological Capacities

Sophisticated Technological Capacities

We pull together sophisticated analytics competencies and advance technology to decrease costs, produce new pilots and accomplish higher levels of accuracy and diligence in our service

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