- Benefits verification & prior Authorization
- Eligibility and Benefits Verification
- Patient Demographics Entry
- Charge Entry
- Medical Coding Services
- Claims Submission Work Edits and Rejection
- Payment Posting Services
- Accounts Receivable Management
- Denial Management Services
- Coding Denial Management
- Credit Balance Services
- Patient Statement Services
Effective Coding Denial Management Services
Coding denials significantly impact revenue cycles, necessitating comprehensive strategies to address them efficiently. Despite well-run revenue cycle departments, over 10% of claims face denials, emphasizing the importance of robust denial management processes.
Understanding Coding Denials
Coding denials often stem from incorrect coding or other coding issues, requiring meticulous review and resolution processes, including retrieving medical records, assessing codes and documentation, and resubmitting claims. This labor-intensive process drains resources and time from coding teams.
Our Comprehensive Denial Management Services
SPECIALIZED BILLING PRIVATE LIMITED offers comprehensive coding denial management services, alleviating the burden of labor-intensive processes and providing coding audit solutions to prevent denials effectively. Our expertise and structured approach enable efficient denial management, facilitating the collection of lost revenue.
Did You Know?
Providers fail to resubmit or appeal up to 65% of denied claims due to resource constraints, including staff shortages and lack of certified medical coders. As a result, addressing denied claims often takes a back seat to processing newer claims, leading to revenue losses.
Medical Coding Expertise
For coding-related claim denials, we deploy certified coders with specialty-specific experience. Leveraging their expertise, we identify issues, apply appropriate medical codes following AMA guidelines, and navigate Correct Coding Initiative (CCI) edits, ensuring accurate claim resubmission.
Benefits of Our Services
- By utilizing our coding denial management services, clients gain access to numerous benefits:
- Improved Revenue Realization: Resubmission of denied claims leads to enhanced revenue recovery.
- Access to Certified Coders: Benefit from a team of certified coders with expertise in various specialties.
- Reduced Days in AR: Efficient denial management contributes to minimizing accounts receivable days.
- Focus on Denial Prevention: Shift focus towards prevention strategies to mitigate future denials.
- Improved Cash Flow: Timely resolution of coding denials aids in optimizing cash flow.
- Cost Reduction: Streamlined processes result in reduced costs associated with claim resubmission.