Denials Management for A Healthy Cash Flow
Systematically investigate each claim, identify the root cause of denials, and take action to reduce the rate of denied claims.
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Claim denials are the number one reason medical billing services fail. About One in every Ten claims submitted are denied by payers, and only 35% of those claims are ever resubmitted by providers.
Denial Management is used in medical billing procedures to keep denials below 5% through recovery and prevention. It is a systemic approach aimed at retrieving lost revenue stuck in accounts receivable and actively preventing unmasked patterns that lead to denied claims from recurring.
Uninterrupted Revenue Flow
Challenges that cause denials to stem from inconsistent documentation or missing information, modifier misuse, improperly coded procedures, incorrect diagnosis coding or code usage issues, as well as eligibility/claim rejections due to missing documents or errors.
At GoBill we implement a solid denial management strategy ensuring our clients get reimbursed for their services faster and achieve a steady flow of cash; our team is dedicated to resolving denials, resubmitting claims to insurance payers, and investigating the root cause of your denials to prevent any future risks.
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GoBill Denial Management Solutions
- Investigate Legacy and Sophisticated Claim Adjustment Reason Codes (CARC).
- Identity Trends/Root Causes of Denials.
- Audit processes for patient eligibility and provider credentialing.
- Correct and Resubmit Denials.
- Sort Denial Codes Into Automated Work lists filtered by relevant factors.
- Devise a workflow for each type of denial work list.
- Correct and Resubmit Claims or Submit Documented Appeals to the Insurer.
- Denials Prevention.
- Monitor the Internal Team and the Insurer to better track and understand each claim denial.
- Use the Information Collected to Apply for a Prevention Program.
- Apply for the prevention program through workflow adjustments, staff retraining, and process revision.
GoBill Denial Management Solutions
- Identify Reasons
- Investigate Legacy and Sophisticated Claim Adjustment Reason Codes (CARC).
- Identity Trends/Root Causes of Denials.
- Audit processes for patient eligibility and provider credentialing.
- Correct and Resubmit Denials.
- Sort Denial Codes Into Automated Work lists filtered by relevant factors.
- Devise a workflow for each type of denial work list.
- Correct and Resubmit Claims or Submit Documented Appeals to the Insurer.
- Denials Prevention.
- Monitor the Internal Team and the Insurer to better track and understand each claim denial.
- Use the Information Collected to Apply for a Prevention Program.
- Apply for the prevention program through workflow adjustments, staff retraining, and process revision.
GoBill Denial Management Solutions
Resolve Denials from the Roots
By enlisting our services, our dedicated team will take charge of eliminating costly errors and delays in your cash flow and ensure 100% accuracy in your reimbursements. Our procedures are tried and tested:
- Proactive Follow-Ups and Denial Prevention
- Negotiate Denials with Claim Adjusters
- Minimize Aged A/R and Bad Debt
- Resubmit and Appeal Claims within 42 Hours
- Support 99% First Submission Claim Acceptance Rate
- Support less than 1% Denials Rate
GoBill investigates and actively shortens your accounts receivable cycle, leading to an improved revenue cycle.
