With so many different healthcare payers, with a variety of reimbursement schemes, it's extremely important to put in place robust processes for managing denials. Follow-up and investigation are time-consuming, and without appropriate focus revenue performance quickly suffers.
But with MedeFinance Denial Analytics, you can more effectively manage payer denials. Denial Analytics is a hosted, always-on, on-demand system you can use to generate the insight into claim denials needed to increase the bottom line and contribute to growth through higher resolution and overturn.
Answer questions like:
- What was denied yesterday, and why?
- What are the common denial reasons?
- Of all the denials, where should we focus our resources?
- What is the root cause for high-value denials? Most frequent denials?
- Who has been most effective at overturning underpayments and denied claims?
- What are our denial and net revenue trends by department, payer, service, or other factors?
- How can I reduce denial costs while keeping my resource demands constant?
Find Out Today What Was Denied Yesterday
Get current and comprehensive analytical details on demand, so you can make decisions and take actions before denials impact the bottom line. Detect underpayments sooner, when you can still intervene. Minimize denial exposure and advance net revenue-recovery by identifying and addressing reasons for non-payment. Use advanced denial root-cause analysis to isolate and manage internal behavior that could result in denials.
Actively Manage Your Denied Claims
Easily create a team work list for incoming denials and alert key personnel when claims exceed targets by reason code, dollar amount, or Six Sigma metrics. Establish targets by functional department, physician, enterprise or other areas. Conduct appeal discussions based on comprehensive retrospective trending and readily available claims information.
Mitigate Payers' Denial Tactics
Get every shred of data you need to negotiate with payers and answer all their questions. Accrue, analyze, and sort the myriad payer denial schemes so you can proactively invalidate payers' denial tactics. Investigate slow payers and accelerate follow-up with longitudinal, time-based views.
Improve Productivity While Lowering Resource Demands
Get your denial scorecard numbers quickly, with no hassle, via a secure, centralized source of intelligence available 24x7 - no more slogging through multiple silos of disparate data sources. Easily assess payer adherence to HIPAA compliance (via EDA 835's) and report gaps.
Strengthen Your Defense Arsenal with Denial Intelligence
Use current information to arm cross-functional areas with actionable denial resolution information, right down to the claim or service-line level. Securely share information across your organization with access controlled by user or role. Conduct powerful root-cause analysis on underlying issues.
Learn next about MedeFinance Payer Contract Analytics, or how you can get started with MedeFinance.
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