Reducing denied claims and recovering lost revenue is a trial for healthcare providers nationwide.
Outsourced denial management solutions give valuable time back to you and reinforce your revenue cycle.
Effective accounts receivable (A/R) denial management is vital to a healthcare provider’s ability to maintain a healthy cash flow and keep their health system in sound shape. Unfortunately, claims denial management is time-consuming for medical professionals who want to focus on providing quality patient care. Outsourced denial management services are a fantastic way to address payer denials without distracting from what matters most for your practice.
Horizon Healthcare RCM understands how challenging it is to deal with A/R denials in a busy practice. Our denial management services efficiently discover and solve denials, improving your long-term revenue cycle management. We apply our advanced coding resources to address issues like medical necessity while you concentrate on improving your patients’ lives.
Our staff is highly trained and familiar with medical terminology. We’re dedicated to a professional lifestyle of continued education and quality assurance.
Our denial management revenue cycle solutions offer:
Abundant payer denials severely impact your revenue cycle and place your health system at considerable risk. Horizon Healthcare RCM helps you prioritize the fine details that have the most significant effect on your reimbursement efforts and create a clear-cut path for lost revenue recovery.
Our advanced denial management software and coding solutions sort out denied claims and offer visibility on your denial workflow and patient experience. We look upstream to determine whether issues like inaccurate patient information, inadequate patient access, or a lack of prior authorization are causing insurers to reject claims. We navigate insurance companies’ appeals processes and work toward delivering clean claims.
Claim denials come in many forms, and the process for addressing an A/R denial is just as varied. Our experienced staff understands medical terminology and has the advanced software to generate detailed and up-to-date reports. We dive into denial rates, win/loss ratios, and rate of appeals to determine how each metric impacts the other and highlight strategies for improvement.
We promote improvement in denial workflow and reduction in denial rates. Even simple mistakes like incomplete patient information can severely derail your A/R denial management efforts. To identify troubling trends and create strategies tailored to your specific situation, we investigate:
Data is the foundation for improvement. Horizon Healthcare RCM has partnered with an advanced software vendor to provide medical professionals with detailed performance reports, inventory reconciliations, root cause analyses, and more.
Medical coders need to have an advanced comprehension of medical terminology, anatomy, and insurance guidelines. A certified coder is well-trained and proficient enough to assign codes efficiently and correctly under every circumstance. Clinicians responsible for patient care and medical billing services are often stretched for time. While patient health should be your priority, the integrity of your health system and revenue cycle is also vital.
Leaving your revenue cycle in the capable hands of Horizon Healthcare RCM’s certified coders is an excellent alternative to building an in-house team. While we address your denial workflow and deliver enhanced reimbursements, you have free rein to tend to the patient experience. Our experts abide by the HIPAA and PHI requirements and ensure the integrity of sensitive information with our SOC 2 Type II certified cybersecurity solutions.