Denial Prevention &
Reimbursement Resolution
Hold Payers Accountable
Overturn Denials
Optimize Reimbursement
Reduce denials by ensuring medical necessity appropriateness to increase reimbursement revenue. Our denial management physician advisors utilize medical judgement in conjunction with our proprietary payer database to reinforce revenue integrity and recover reimbursement.
Reduce Initial Denials
Continual communication between the hospital utilization management team and our physician advisors
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Address Claim Denials
Advocating for change in status or reconsideration
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Reclaim Revenue Earlier
Reduce the number of initial denials to avoid delays in the revenue cycle
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Recover Reimbursement Revenue
Hold payers accountable and get paid for the care you provide.
Payer Peer-to-Peer Reconsideration Reviews
Submission deadlines and lack of resources shouldn't prevent you from resolving medical necessity before the claim is submitted. Recoup dollars by getting appeals overturned to increase reimbursement revenue.
Appeal Reviews
Our physician advisors review denied inpatient stays and recommend appeals when appropriate.
Return on Investment
Our hospital clients see positive ROIs with our Payer Peer-to-Peer Reconsider Review offering, typically in excess of 4x! Our dedicated denial management team takes the burden off of hospitals, facilitating the entire process to ensure that the reconsideration review period is maximized, allowing our hospital partners to reclaim revenue earlier.
Proprietary Payer DatabaseOur payer database is continually updated to reflect payer trends, tactics and policies, as well as key factors that play into how payer medical directors make determinations.
Optimize Revenue CycleIncrease cash flow by taking advantage of the reconsideration review period by initiating a payer peer-to-peer. These are the closest thing to a gift that a hospital can expect, so take advantage of this opportunity.
Ensure Revenue IntegrityHold payers accountable and fight back. Contact us today to learn how you can achieve a positive ROI by challenging denials.
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
