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Denials Management Monitoring

Denials Performance Through Data Analytics in Healthcare
Reviewing digital reporting on tablet

Our tool can help reduce revenue loss and collection rework costs from insurance denials.

The platform provides actionable data that allows for root-cause analysis and an effective denials prevention strategy.

In our experience, organizations frequently have initial claim denial rates of 10% or more. Rework expenses from preventable denials are costly, and write-offs associated with denied claims can cost an organization 3% or more of its annual net revenue, significantly impacting the ability to reinvest in patient care. Do you know your organization’s denial rate?

It is critical to address denials proactively. Our reporting and measurement tools help organizations understand their denials performance, write off expenses, establish a data-informed prevention strategy, and get started quickly with a versatile, agile tool.

 

Help Improve Denial Rates

Our tool is structured to help your organization avoid and prevent revenue loss from insurance denials. The tool provides the ability to monitor, measure, and benchmark your denial performance trends at an organizational level and for specific locations, departments, services, and denial types. It allows for data mining and claim-level detail to assist your organization in uncovering and resolving root-cause issues driving denials. In addition, this tool helps guide your revenue cycle and process improvement teams so they can focus on issues having the largest impact on your organization.

Help Improve Staff Efficiency

Insurance denials can be overturned but often require extensive rework, clinical knowledge, and significant operational labor costs in order to resolve successfully. Our tool is designed to provide visibility and help your organization uncover and resolve high-volume denial trends that are leading to considerable rework costs for your organization.

Help Improve Patient Experience

Insurance denials can and do impact the patient experience, whether through requiring the patient to navigate and participate in a lengthy and complex appeal process or receiving an unexpected bill for a service the patient thought would be covered. Our analytics tool can help organizations identify and reduce denials that may ultimately be impacting the patient experience at your organization.

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