Insurance Billing + Follow Up Payment Variance + Denial Solutions

Utilizing RPA technology to obtain real time claim status from payers gives us access to more detailed information, allowing us to resolve problematic claims sooner. Seamless and rapid interpretation of data enables us to identify denials and other claims issues. Our clients receive an in-depth analysis into payer-specific trends or internal system issues with tangible solutions. We take a collaborative approach when implementing our strategy and work with all departments to reduce denials.

Our proprietary solution drives our payment review process. Leveraging RPA, we identify line-item denials on high-cost items, and our team ensures payers reimburse our clients appropriately for carve-outs in compliance with contractual agreements. Payment variances are identified, analyzed, and resolved. Our process leads to a reduction in write-offs and an increase in revenue collection. Some specialized service areas requiring this attention are:

 

  • Mental Health Crisis Management

  • Medical Substance Abuse

  • Ambulatory Surgery

  • Chemotherapy + Radiation Oncology

  • Hyperbaric Oxygen Therapy

  • Hemodialysis

 

Maximizing reimbursement from all insurance carriers is crucial for all facilities. Effective contract management is essential in a successful provider + payer relationship. Analyzing payer trends, denials, and patterns is crucial to enforcement.