Denial Management Services

Are partial or underpayments causing financial burdens on your healthcare practice? Don’t lose hope. BilNow provides advanced denial management solutions to find the root cause of medical claim denials,  fix the problems, and help you get paid faster. 

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Root Cause Analysis

Our customized claim denial management services enable you to save millions of dollars annually, offering a bright financial outlook. First, we decide on key performance indicators to track the performance of your medical billing system. The next step is to dig deeper into your revenue cycle management to identify the significant causes holding you back from meeting the billing collection targets

Certified Medical Billing

Collaborative Action Plan

After a detailed root cause analysis, we plan to eliminate the possible cracks in your healthcare billing services. We will work with your entire revenue cycle team, including the front desk and back end, to determine why things are going wrong and how to eliminate the red flags. At this stage, we set quantifiable goals with healthcare providers, including the desired percentage of clean medical claims, i.e., 99%, and a timeline to achieve them.

Implementing Proven Denial Management Strategies

We implement our strategy with a plan and goals. We resubmit denied or rejected claims within a given time window. We follow the best possible procedure to scrub the claims and help practitioners recoup financial losses by successfully appealing the denied claims. We understand that timelines and quality matter when dealing with claim denial management services. We don’t hesitate to provide realistic deadlines and goals to show our commitment to excellence

Our denial management services are tailored to your practice’s unique needs. BilNow’s medical billing experts implement robust solutions to fine-tune the claims management process.

Moving From Denial Management to Prevention

“Prevention is better than cure.” This is what we believe in. Our denial management experts closely monitor every aspect of the revenue cycle, from patient scheduling and registration to clinical documentation, medical coding, charge entry, claims submissions, and accounts receivable management, to identify and fix the problems slowing down your medical billing process.

By preventing billing errors from recurring, we help practitioners shift the focus from denial management to denial prevention.

Keeping Up With Payers' Guidelines

We understand the importance of keeping pace with payers’ requirements. Every payer has different rules and regulations regarding filing denied claims. Experts at BilNow fully understand the payer’s guidelines and submit the claims accordingly within the insurance companies’ time frames. So, outsource denial management services to us and forget about claims getting denied because they do not fulfill the criteria set by the concerned insurance payers. We go beyond expectations and ensure a healthy payer-provider relationship.

Our Denial Management Process

Our denial management process is comprehensive and systematic. Our process involves:

Denial Tracking

The first step is to identify and categorize all denied claims. A key component of this process is tracking and understanding denials through electronic remittance advice (ERAs) and explanations of benefits (EOBs).through electronic remittance advice (ERAs) and explanations of benefits (EOBs).

Identifying Causes

We perform a detailed root cause analysis to identify the reasons for denials. This process may include coding reviews, eligibility verifications, medical necessity assessments, and more.

Denial Resolution

Once we identify the issues, our experienced team will resolve them on your behalf. This could involve correcting coding errors, providing additional documentation, or appealing denials based on incorrect information.

Appeal Preparation

We prepare detailed appeal letters for denials that require appeal, presenting clear arguments supported by acceptable clinical documentation and applicable regulatory norms.

Continuous Improvement

After managing denials, we analyze trends and patterns to identify areas for process improvement. These could include training coders, improving documentation standards, or improving patient eligibility verification.

Detailed Reporting

We provide detailed reports to healthcare providers regarding the ongoing progress in their revenue cycle management so they can stay updated with the ins and outs of their medical billing system.

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Capture Every Dollar You're Owed

We always consider denial management important and capture every penny for the services rendered, so you don’t need to worry about your finances! We will manage your revenue cycle with the utmost priority, just as you prioritize your patients.