Denial Management Services
Certified & Accredited
Superior Health Care
Quality Customer Care
What Is Denial Management?
At Healthcare Protectors, we recognize that efficient revenue cycle management is crucial for healthcare providers. Our Denial Management services are designed to tackle claim denials head-on, ensuring that your practice receives the reimbursement it deserves. Let’s dive into the details.
Denial management refers to the strategic process of examining, correcting, and preventing claim denials. When a payer (such as Medicare or a commercial health insurance company) denies a provider’s request for reimbursement of medical services, it results in a **claim denial**. Our team specializes in identifying, addressing, and resolving these denials promptly.
Why Denials Occur
Several factors contribute to claim denials:
- Coding Errors: Incorrect or incomplete codes can lead to denials. Our experts meticulously review claims to ensure accurate coding.
- Lack of Medical Necessity: Payers may deny claims if they perceive a lack of medical necessity. We work to provide comprehensive documentation to support each claim.
- Eligibility Issues: Verifying patient eligibility is crucial. Our system cross-checks patient information to prevent eligibility-related denials.
- Insufficient Documentation: Clear and thorough documentation is essential. We assist providers in maintaining robust records to prevent documentation-related denials.
Our Denial Management Process
- Identification: We proactively identify claims rejected due to clerical deficiencies or denied by insurance companies. Timely action is critical.
- Investigation: Our team investigates the root causes of denials. Was it a coding issue? Did documentation fall short? We leave no stone unturned.
- Resolution: Once identified, we address denials promptly. Whether it’s resubmitting claims, appealing decisions, or providing additional documentation, we take action.
- Prevention: Prevention is key. We analyze patterns, implement corrective measures, and educate your team to minimize future denials.
Meet Our Doctors
Devon Lane
Plastic Surgery Doctor
Cody Fisher
Plastic Surgery Doctor
Esther Howard
Plastic Surgery Doctor
Jenny Wilson
Plastic Surgery Doctor
