Expert denial management services that review, correct, and resubmit denied medical claims to recover your lost revenue
Recover Your Revenue NowDenial management services involve the process of picking, examining, and settling claims that have been denied by the insurance. It concerns seeking the reasons behind the denial, addressing the mistake by accurate coding, incomplete documentation, and refiling the claims. This will minimize revenue leakage and enhance healthcare providers' cash flow.
Effective healthcare denials management also assists in preventing future denials as it deals with the causes and ensures billing accuracy.
At SHMEDEX, we do more than the conventional medical billing practice; we provide specialized denial management services. Our team of skilled coders and appeal experts, with their extensive experience and knowledge, only practices on denied claims, ensuring each one is checked thoroughly and rectified.
We manage resubmissions, re-contact payers, and strive to achieve immediate payments. Our denial management in medical billing would lead to fewer claims getting rejected, a reduction of the payment cycle, and better financial outcomes for your practice.
Sick of your claims being denied and slowing everything down? As a healthcare provider, your primary interest is in providing treatment to your patients, and when claims are denied, it causes delays, creates unnecessary work, and impacts your finances.
Getting these problems fixed can be frustrating and time-consuming, as you keep your practice running well. This is where denials and appeals management come in, as far as healthcare is concerned.
Incorrect ICD-10, CPT, or modifier usage
Coverage terminated, patient not found, or inactive policy
Missing pre-authorization or referral requirements
At SHMEDEX, our procedure begins with a root cause analysis to establish the real cause of every denial claim. This proactive approach enables us to develop simple-to-follow strategies for the prevention of claim denials, ensuring future issues are minimized.
Our denial management in healthcare creates solid appeals, and we pursue the insurance companies until the claim is paid.
Payer-specific denial trends are also monitored and help us reveal the causes of rejections.
Our team takes care of any problems that might occur in terms of missing documents, wrong code, or patient eligibility, among others, as soon as possible.
Comprehensive solutions to maximize your revenue recovery
We look closely at every claim that has been denied to determine the precise reason that it was denied. Our team conducts a thorough root cause analysis to find the root cause in order to fix it and prevent future occurrences.
We rectify the claim, fill in the missing information, and resubmit the claim to the insurance company. Our team achieves a high approval rate and minimizes the amount of delay, enabling our customers to get paid more quickly.
In case a claim is unreasonably rejected, we manage the review procedure. Our denial management specialist develops high-persuasion letters, attaches all necessary documentation, and ensures we pursue the end when we have a final response.
We monitor and analyze the trend of denial in every insurance conglomerate. In healthcare denial management, we customize our process to comply with certain payer rules and assist our clients in avoiding denials in the future.
We provide clear reports showing denial reasons, success rates, and areas to improve. Our reports help healthcare providers see where problems are happening and how we're working to fix them.
Using what we learn, we create simple and effective strategies to stop denials before they happen. Our prevention plans focus on better coding, documentation, and workflow so our clients can run their practices smoothly.
At SHMEDEX, we understand that wrong or absent medical codes are among the highest causes of denials of claims. Our coding denial management services are geared towards determining and rectifying coding problems, which cost you money.
We also scrutinize rejected claims, reprocess any coding mistakes, and ensure that the codes are proper as per the medical records. Denial management in medical coding curbs denials in the future and guarantees that proper claims are reported at first instance.
We have highly trained coders who are conversant with various payer regulations and are up-to-date with the current coding rules. We collaborate with providers in enhancing documentation and coding correctness, resulting in increased clearance and decreased denials.
Through better coding, we can make sure that healthcare providers get paid and maximize their revenue. You will have a chance to take care of patients and leave your coding and claim problems to us with our assistance.
Average recovery rate for coding-related denials
How we help transform your revenue cycle performance
We identify and address patterns of denial and relate directly and promptly so that our staff does not have to wait to correct and refile claims. This minimizes the time and helps our cash flow so that staff spend less time tracking down payments.
We specialize in appealing denied claims effectively. Our team reviews every case thoroughly and provides the right documentation, helping your practice recover lost revenue and maintain profitability through our strategic denial handling.
We are not only correcting the claim denials, but we also analyze their causes. Our team determines the reasons behind coding errors, documentation, or payer policies and alters the processes to avoid such denials in the future.
We stay current with all-payer rules and policy updates. Our familiarity with insurance requirements effectively takes care of even more complicated issues, and our appeals pass inspection.
Our denial management in medical billing, from start to finish, significantly reduces the burden on your internal staff. With our support, your team can concentrate on patient care while we handle the time-consuming follow-up work.
We provide tailored reports and in-depth insights into your denial trends. Our data helps you make informed decisions, optimize billing practices, and strengthen overall revenue performance.
We work with your practice and have an experienced team. Our assistance is regular, in-depth, and with clear communication to address denials effectively and as soon as possible.
We offer a cost-efficient way to recover denied revenue. Our services reduce billing errors, increase collection rates, and provide long-term financial benefits for your practice.
We are aware of the frustrations that occur when one is denied a claim. Our medical denial management services at the hospital concentrate on factors that cause these denials, which include wrong codes, absence of information, or authorization problems.
We review every denied claim, make corrections, and resubmit it so that your hospital is paid for the services offered.
Denial management in medical coding is important in saving the hospital's revenues. In cases where there are errors in coding or billing, claims are rejected or delayed. We assist in solving these issues within the shortest time possible because we are aware of the regulations in coding and insurance terms.
With our assistance, hospitals may minimize rejections, accelerate payments, and increase their total revenue cycle.
Claim denials in medical billing are a time-consuming and expensive process for any healthcare practice. At SHMEDEX, we aim to manage a medical billing denial challenge by getting to the bottom of the problem and fix it as quickly as possible.
Get Denial SupportAnswers to common questions about our denial management services