Recover lost revenue, reduce denial rates, and optimize your revenue cycle with our comprehensive denial management solutions.
Reduce Denials NowTransforming denials into revenue opportunities
Denial management is the systematic process of identifying, managing, and appealing denied insurance claims to recover lost revenue. It involves analyzing denial patterns, addressing root causes, and implementing strategies to prevent future denials.
Effective denial management is crucial for maintaining a healthy revenue cycle. The average medical practice loses 5-10% of its revenue to denials, but with proper management, up to 90% of denials can be successfully appealed and recovered.
At CareAxis, we've developed a sophisticated denial management system that combines advanced technology with expert human analysis. Our approach not only recovers denied claims but also identifies patterns to prevent similar denials in the future.
We handle the entire denial management process, from initial denial analysis to appeals submission and follow-up, allowing your team to focus on patient care rather than administrative tasks.
Comprehensive analysis of denial patterns to identify root causes and trends.
Expert preparation and submission of appeals with supporting documentation.
Implementation of strategies to prevent future denials and improve clean claim rates.
Explore the most common reasons for claim denials and how to address them
Eligibility-related denials occur when a patient's insurance coverage is not active at the time of service or the patient's information is incorrect.
These denials occur when services require prior authorization but were performed without obtaining proper approval from the insurance company.
Coding denials occur when there are errors in CPT, ICD-10, or HCPCS codes, or when codes don't align with documentation.
These denials occur when claims are submitted after the payer's specified filing deadline, typically 90-180 days from date of service.
These denials occur when clinical documentation doesn't support the medical necessity of the services billed.
Systematic approach to identifying, managing, and preventing denials
We systematically identify and categorize all denials by type, payer, and reason to identify patterns and root causes.
Our experts perform deep analysis to identify the underlying causes of denials, going beyond surface-level reasons.
We gather all necessary documentation, clinical evidence, and supporting materials to build strong appeals.
Appeals are submitted following payer-specific requirements and tracked through resolution with regular follow-ups.
Based on denial patterns, we implement targeted strategies to prevent similar denials in the future.
We provide detailed reports on denial rates, recovery success, and improvement trends to measure progress.
Comprehensive approaches to reduce denials and increase recoveries
Advanced analytics to identify denial patterns, trends, and root causes across payers, providers, and services.
Expert appeal preparation and submission with supporting clinical documentation and follow-up until resolution.
Targeted education for providers and staff on documentation, coding, and compliance to prevent denials.
Workflow redesign and process improvements to address systemic issues causing denials.
Maintenance of up-to-date payer-specific requirements and policies to ensure compliance.
Real-time dashboard tracking denial rates, recovery success, and key performance indicators.
Talk directly with our experts and get started today.
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