Intro

Denial management is an important part of medical billing that can greatly impact how much money healthcare providers make. At PMBS, we know how hard and frustrating it is when a claim is denied, and we want to help providers improve their revenue cycle by managing denials well.

Simplifying Denial Management for Healthcare Providers

Denial management can be difficult and time-consuming, but with PMBS, you can be certain that your denied claims are in good hands. Our team of specialists is familiar with the most recent best practices for denial management and has a track record of assisting healthcare providers in recovering lost revenue.

Denial management is essential to medical billing because it ensures that healthcare providers get paid what they are owed. According to the Healthcare Financial Management Association, the average healthcare provider experiences a denial rate of 5-10% of their total claims submitted. This can cause providers to lose a lot of money, so managing denials is important in staying financially stable.

Comprehensive Denial Management Services

• Appeal letter preparation and submission
• Resubmission of denied claims
• Analysis of denial trends and root cause analysis
• Training and education on denial management best practices

Get Back on Track with PMBS’s Denial Management Services

The denial management services from PMBS are meant to help you get back lost money and get your billing processes back on track. Whatever the reason, the majority of claim denials are due to human error. PMBS is staffed with the top medical billing and coding experts, all of whom have been hand-picked for their knowledge in the field.

These experts are always involved in ongoing staff education programs to ensure that they have the most up-to-date knowledge of billing and coding regulations.

Insurance companies generally maintain a list of operations or diagnostic combinations they will cover. PMBS maintains an up-to-date database of permitted pairings by various insurance providers. Our highly authorized coders ensure that the highest paid and highest approved mix of procedure and diagnosis codes is employed to achieve maximum pay.

Don’t let denied claims impact your revenue. Contact PMBS today to learn more about our denial management services.

The Importance of Effective Denial Management

The healthcare industry is constantly evolving, and with changes come new challenges. With the rise of high-deductible health plans and more rules from the government, it’s become common for healthcare providers to have their claims denied. The monetary impact of denied claims can be mitigated, and revenue maximized through efficient denial management.

• To identify the reason for each denial
• To reduce the cost to collect
• For a seamless integration of software and efficient workflow to prevent the future recurrence of denial
• To deal with denials within 48 hours of receipt
• To study denial trends and patterns and identify the root cause of costly denials
• To enhance the account collections and manage denials efficiently
• To reduce manual work and effort involved in checking denial errors

Our Approach to Denial Management.

When it comes to dealing with denied claims, PMBS takes a holistic approach. To guarantee that your claims are being processed quickly and accurately, our team of specialists works together to determine the cause of denied claims, implement efficient solutions, and monitor your claims. Our goal is to help you recover the maximum possible revenue while improving your overall revenue cycle management

Identifying the Root Cause of Denied Claims.

Identifying the root cause of denied claims is essential to take the necessary steps to correct them and reduce further denials. We will analyze the data to pinpoint where adjustments need to be made, develop strategies to combat the recurrence of the same denials and work with you to ensure that all claims are processed accurately and efficiently. This allows us to implement targeted solutions that address your specific challenges.

Implementing Effective Solutions.

We’ve put together a special team with much experience in analytics and customer relations to do this. This could mean updating your billing and coding processes, negotiating with payers, and speaking up to make sure that claims are paid fairly and correctly.

Monitoring Claims for Maximum Efficiency.

We understand the importance of accurate and prompt reimbursement, so we have established a detailed and consistent process for reviewing all claims. To keep your revenue cycle running smoothly, we employ state-of-the-art tracking technology to monitor the development of your claims and spot any potential problems ahead of time.

The Benefits of Working with a Denial Management Company.

A denial management company can assist healthcare providers in many ways. These organizations have the skills and resources to extensively investigate denied claims and develop effective recovery tactics. They can also provide ongoing monitoring and support to prevent future denials. By working with a denial management company, healthcare providers can save time, improve their revenue cycle, and focus on giving their patients good care.