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The denial management process is vital to establishing rapid cash flow and maximized revenue collections. While payers may state a simple reason or provide a code signifying why they decided to deny a claim, the reality is that effective denial management entails meticulous detective work in order to make sure that upon resubmission, the claim be accepted. Failure to do so results in tied-up claims and denials that never materialize into revenue, and this has a significant detrimental impact on medical practices.
To ensure denial minimization on the front-end, efficiently resubmit denied claims, and maximize the acceptance of denied claims for total claim reimbursement, leveraging Avosina’s denial management process flow will vastly benefit your practice. The purpose of your organization is to serve patients, not scramble about and wrestle with insurance companies trying to understand how to get paid while tracking down claims. This is what Avosina’s denial management professionals do every single day and are true experts at.
Every denied claim requires a unique process of its own to manage in order to get paid on in the future. Upon discerning the rationale for a denial, Avosina uses an aggressive, systematic, best practices approach to combat denials and ensure that you get paid what is properly owed to you effectively and efficiently. Our in-house, proprietary technology monitors systematically scheduled follow-up timeframes which are addressed by our denial management professionals in a no-nonsense, best practices manner, displays to you all the aspects of why denials have occurred and at what step in the re-submission process each denied claim lies in real-time, and enables you to learn how your medical practice can avoid future claim denials.
Critical to our denial management process is efficiency in rapid reimbursement turnaround, maximization of payment, and strategically denial prevention. Beyond the simple code scrubbing tools that most medical billing services and MER/PM systems utilize, Avosina’s proprietary, easy-to-use, “one-look” tools actually clarify the exact rationale for the denial, populates the status of every single denied claim so to never miss one, and quantifies denials into observable trends, thus enabling strategic front end clean claim maximization, back end payment maximization, and accelerated payment.
With Avosina, you have a dedicated denial management team focused on analyzing and assessing the best next action steps and re-submitting claims to maximize reimbursement as rapidly as possible. We establish workflow rules in accordance to your specific practice needs and SOPs to prioritize claims based on amount, age, and payer, thus ensuring robust cash flows and maximized reimbursements. As we assess denial patterns and learn about specific trends impacting your particular practice, we teach your practice about how to minimize future denials and maximize front end clean claim acceptance.
We’re on a mission to fully harness the robust internal infrastructure of our RCM and IT expertise coupled with our vast external professional healthcare management and leadership networks in order to continually maximize our clients profits and drive the development of prosperous, hassle-free private practice independence.
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