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AR and Denial Management

Denial management is an integral part of the medical billing RCM process. It is deeply connected to the reimbursements from health insurance companies. Insurance claim denials are frustrating for any practice because they are time-consuming and delay reimbursements by weeks or longer. PLUTUS HEALTH denial management process resolves the problems leading to denials and shortens the accounts receivables cycle.

Denial management is very critical in a successful revenue cycle management that will lead to healthy cash flow.  The below four steps identify, resolve, and prevent denials by addressing the root cause.

Denial Management in Healthcare

Medical practices should aim for a 95% clean claims rate; otherwise, it is equivalent to dropping the money on the table. Maintaining a high clean claims rate increases your medical practice’s efficiency and overall profitability.

If your practice continues to have claims denied, your insurance reimbursements will decline.  Many practices work on small margins, and even a slight change could put your practice a risk.

4 Ways to Prevent Medical Billing denials:

  • Keep up with the latest knowledge on denials
    We need to keep up with the latest changes in medical billing, and it’s essential to understand and reciprocate on challenges and solutions.
  • Code all claims as per the requirements
    Incorrect coding is a significant loss of potential revenue. Getting the perfect code for the claims is a complex task; while we have PLUTUS HEALTH has some rich experience to enable good coding practice, which improves correct payment collections.
  • Do Transmissions timely and appropriately
    Timely filing denials are a potential loss of revenue, and without the proof of timely filing, these denials will not be paid. Transmission of claims on a timely basis is significant in the medical billing process. 
  • Lookout for Incorrect and Missing information
    Scrubbing your claims before the submission is one of the proven methods to reduce the chances of denials. We at PLUTUS HEALTH have our team with expertise in scrubbing claims to ensure an excellent first pass ratio.

Partnering with PLUTUS HEALTH will bring you the best denial management system and processes. Our Denials percentages across multiple clients are the least in the industry. We help medical practices streamline their revenue inflow and provide access to a knowledgeable team that helps prevent denials from small clinic clients to large physician groups.

Improved collections with effective denial Management:

Denials tend to delay claims processing time and prevent you from getting paid what you are expecting. Denials depend on the pay or and location; therefore, we do not have a one-size-fits-all method in addressing denials.

We at PLUTUS HEALTH create a team of staff that understand denials specific to your location, making identification, analysis, and prevention of denials much easier.

Daily tracking of current denials and pushing back to insurance within 48hrs makes a massive difference on the collections for those claims. We take a multi-step approach in resolving denials that are linked with faster claim payment and a better time to pay for the claims.

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