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Denial Prevention & Appeal Management

Prevent Denials
Optimize Reimbursement

Overturn your denials using our preparation, flexibility and payer-specific knowledge. Avoid denials utilizing Payer Peer-to-Peer Reconsideration Reviews prior to claim submission.

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    Reduce Initial Denials

    Continual communication between the UR team and physician advisors

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    Hold Payers Accountable

    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

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. These reviews are facilitated by two physicians.

 

Appeal Reviews

Our physician advisors review denied inpatient stays and recommend appeals when appropriate. Two physicians assess each review.

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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Optimize patient care, reduce denials and maximize reimbursement through our unique approach to achieving excellence in utilization review.

Discuss your hospital's denial prevention and appeal management needs with our team.

 

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