Denial Analysis team provides an insight into the types of denials a client receives, the appropriateness of these denials, and the best way to achieve resolution and payment. A team is also put into place to enable the timely filing of appeals, obtaining and submitting medical necessities and also initiating effective tracking and trending of denials. This system helps draw up denial prevention strategies, apart from resolving denials at lower administration costs.
Following are the actions that would be taken on Denials/Rejections:
Actions and resolution on Regular Mails
No coverage at TOS
Benefits Exhausted
Non-Covered Services
Unable to Identify Patient
Require Medical Records/Denial for Medical Necessity
Denial Analysis team provides an insight into the types of denials a client receives, the appropriateness of these denials, and the best way to achieve resolution and payment. A team is also put into place to enable the timely filing of appeals, obtaining and submitting medical necessities and also initiating effective tracking and trending of denials. This system helps draw up denial prevention strategies, apart from resolving denials at lower administration costs.
