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Denial Management

At BuiltAbility, our team will investigate each denied claim, perform a root cause analysis of denials, identify common trends that are causing denials and help you devise strategies and plans to avoid future denials. Our goal is to reduce denials to as low as five percent giving you a major revenue boost.
Every year healthcare providers lose a large proportion of revenue because a large proportion of rejected claims go unattended and are never resubmitted. BuiltAbility’s Denial Management process uncovers and resolves the problem leading to denials and shorten the accounts receivables cycle. Our expert denial management team will establish a trend between individual payer codes and common denial reason codes. Identifying this trend will help the provider to reveal billing, registration, and medical coding process weaknesses that are then corrected to reduce future denials, thus ensuring first submission acceptance of claims. Also, We will analyse payment patterns from various payers and will set up a mechanism to alert when a deviation from the normal trend is seen.

Denial management is a crucial aspect of the medical billing process aimed at identifying, resolving, and preventing claim denials from insurance companies. Denials occur when insurance companies refuse to pay for healthcare services, either partially or entirely, due to various reasons such as coding errors, incomplete documentation, lack of medical necessity, or eligibility issues. Effective denial management helps healthcare providers minimize revenue loss, improve cash flow, and optimize the reimbursement process. Here’s an overview of the denial management process:

 

  • Identification of Denials
  • Analysis and Root Cause Identification
  • Resolution and Appeal
  • Tracking and Follow-Up
  • Process Improvement
  • Reporting and Analysis
  • Collaboration with Payers

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