Appealing Medicare Advantage Denials Can Pay Off

Despite a high probability for success, just one percent of Medicare Advantage (MA) reimbursement and pre-authorization denials were appealed by providers and beneficiaries between 2014 and 2016. Hospitals and other organizations need to pursue the MA appeals process to ensure every dollar you’re entitled to is received.

Improve Denial Management with Intelligent Automation

Like an injury that won’t heal, claim denials represent a chronic and growing financial problem for hospitals and other providers, both in terms of lost revenue and the ongoing costs of remediation. Using intelligent automation to automate root cause analysis and the accounts receivable recovery and resolution process can have additional benefits over standard technology.

Reducing Financial Risk Associated with Major EHR and Software Implementations

Like costly home improvement projects gone awry, electronic health record (EHR) and revenue cycle management software implementations don’t always pan out as intended for hospitals and health systems. But with the right tools and proper planning, potential issues can be minimized.

Pre write-off Insurance Collections Help Convert Denials to Cash

Hospitals often assume they have no choice but to accept denial write-offs as an unfortunate but inescapable fact of life. But just like football teams that push the ball over the goal line in a final effort to score a touchdown on a fourth down, hospitals and health systems are turning to pre write-off insurance collections to make one last attempt to pull cash to their bottom line.

Contractual Denials

Top Two Contractual Issues That Trigger Denials

If you want to be sure payers consistently reimburse your organization in a timely and accurate manner, it’s important to comply with all contractual requirements – while making certain the payer does, too. Learn more about two major issues that can trigger contractual denials.

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