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Protecting Revenue Integrity
Our denial management and physician advisor services increase reimbursement revenue and shorten your revenue cycle through solutions aimed at reducing denials.
We partner with all size hospital and health system utilization management teams to provide denial management and physician advisor services to increase reimbursement revenue through our unique approach to utilization case review. Our solutions help hospitals:
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BOOST REIMBURSEMENT REVENUE
though timely utilization management aimed at minimizing denials.
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REDUCE DENIALS & INCREASE COMPLIANCEwith a unified utilization management approach to medical necessity determinations.
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MAXIMIZE REVENUE CYCLE with utilization management expertise facilitated by physicians with payer and hospital experience.
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OVERTURN DENIALS & HOLD PAYERS ACCOUNTABLE
with a team dedicated to reinforcing revenue integrity and resolving reimbursement.
We overturn denials to increase our hospital clients’ reimbursement revenue and shorten the revenue cycle with accurate medical necessity determinations. This allows our clients to provide the most appropriate and effective clinical care.
DENIAL MANAGEMENT PHYSICIAN ADVISOR SOLUTIONS
Our sole focus on denial management and utilization analysis allows our hospital and health system clients to improve quality of care and length of stay with physician-directed discernment and healthcare analytics.
We provide monthly detailed analytics to help our hospital partners identify opportunities for improvement. Our quarterly meetings are deeper dives into the data to help our clients understand utilization trends impacting their hospital. That data usually includes reimbursement metrics and revenue optimization as well as interpreting key performance metrics.
Some of our data sets include the following healthcare analytics:
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- Case type & classification
- Redirection insights
- Payer information
- Length of stay observation metrics
- Payer peer-to-peer metrics
- Internal peer-to-peer metrics
- Appeal insights
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![Dealing with Denials Dealing with denials, a compendium of research by AppriseMD](https://apprisemd.com/wp-content/uploads/2022/05/Dealing-with-Denials.webp)
Dealing with Denials
Ultimately hospitals and other healthcare providers can no longer ignore the impact inpatient denials can have on their cash flow. Ninety percent of all denials are preventable, so why aren’t more denials being prevented?
A compendium of research compiled by
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