Elevate offers a full-suite of healthcare denial management services that include AR follow ups, claims status checks, resolution of denied claims, preparing an appeal letters etc. – all done with one goal in mind which is to collect all dollars due you for medical billing services rendered.
It is important to note the terms claim denial and claim rejections are often used interchangeably by office billing personnel as both may be considered part of the denial management processes. Rejected claims will not be processed as they have not been received/accepted by the payor, therefore, these claims do not make it into the adjudication system. This simply means that a rejected claim must be submitted when the errors are corrected. Often times this causes a reduction in cash flow because no one is looking at system rejected reports or they belief they will receive a denial EOB. Is your staff looking and resolving rejected claims sent to the payer via either electronic data interchange (EDI) or paper? A denied claim has been received by the payor and has been adjudicated and payment determination has already been processed. A denied claim has been determined by the insurance company to be unpayable. Denied claims represent unpaid services and lost or delayed revenue to your practice. Does your practice execute a denial management strategy- process?