Medical Practice Denial Management

If your practice doesn’t have a good denial management process you are leaving money on the table.

That is money that you worked hard for, and it rightfully belongs to you.  Without exception every provider indicates that their biggest concern is that claim denials aren’t being worked and resolved. This is a legitimate concern because denial management is hard work, resource intensive and time-consuming.

Did you know that CMS rejects nearly 26% of all claims and up to 40% of those claims are never researched, corrected, and resubmitted? This results in lost revenue. However, with the proper revenue cycle processes, consistent denial management, and efficient workflows in place, you can increase reimbursements, maximize cash flow, and decrease bad debt write-offs.

Who works your denials?  Does the billing company expect your staff to do this?  Are you expecting your in-house staff to resolve denials?  Everyone maybe well-intentioned but there are challenges to denial management that can result in the denials laying fallow.  

The AMA found that practices spend roughly $26,000 on re-working claims, including phone calls, investigative work, and claims appeals and it doesn’t always result in getting the claim paid.  So, you can see why private practices can’t or don’t always follow-up on denials and you can understand why some billing companies create ‘denial buckets’ for the client to work.

At Onpoint, we take a more proactive claims denial management process.  Working denials isn’t just about fixing the denied claim and moving on to the next one. It is about analyzing the denials, determining their root cause, and implementing action plans to eliminate the cause. This is just one of the many ways Onpoint excels. Let Onpoint collect every penny owed to you. We want to be a part of your team. Every claim, every dollar, every day.