There’s no denying that denials challenge the revenue cycle. Denied, suspended, pending or lost claims are impeding your financial performance.
The denial management process can be tedious, taking too much effort, too many resources and far more time than it should while still providing disappointing results. With the right denial analysis and automation however, healthcare organizations like yours can manage denials effectively and increase collections significantly.
Denials Workflow Manager integrates the power of workflow, enhanced claim status, remittance detail, and analytics to optimize follow-up activities. The solution identifies denials, holds, suspends, zero pays, as well as appeals won or lost with payers through a combination of Electronic Remittance Advice (ERA) and enhanced claim status transactions. This allows providers to optimize claims follow-up by identifying and targeting the claims that need attention as quickly as possible.
Denials Workflow Manager eliminates the need for manual review of claims status and/or remittance advices. The advanced solution provides a view of which claims require follow-up, categorized by root cause, so you can efficiently resolve.
Poor data collection in patient access? Incorrect coding, charges or documentation? Incomplete claims? Denials Workflow Manager helps you determine why claims are denied, giving you the information you need to fix problems and resubmit or appeal. Armed with insights derived from Experian Health’s analytics, you can put best-practice processes in place to prevent them from happening again.
Our integrated denials management solution helps healthcare organizations quickly identify denied claims—so they can be followed up and paid. The tool also spots trends—so they can be addressed and eliminate future payment delays.
ClaimSource® provides the workflow and automation you need to prioritize claims that need attention and minimize financial impact.
Verify the accuracy of payment received from third-party payers.
Enhanced Claim Status allows you to accelerate follow-up and improve cash flow.