Services for managing denials and accounts receivable.
Utilize
our A/R and rejection management tools to increase reimbursement while lowering collection
costs.
Time is money in the medical field. Having an effective and efficient accounts receivable and denial management process is essential to a healthcare organization's profitability. We can efficiently eliminate unnecessary write-offs, A/R days, and cash flow for your company thanks to our years of experience.
Management of Accounts Receivable
The margins, debt, and overall financial health of a provider will all be negatively impacted by A/R problems. A/R management is therefore essential following claim submission and essential for maintaining financial stability. It identifies the claim's adjudication status and aids in comprehending the claim's outcome. Early notice of a denial enables the claim to be corrected at the outset and prevents it from becoming 'untimely' for appeals or corrections. Our experts will examine your financial records, spot mistakes, and put in place effective procedures to recover payments and quickly clear backlogs of unsettled A/R.
Our services for managing receivables:
Follow-up on unpaid accounts receivable for all payers.
A/R cleanup tasks inherited.
Management of underpayments.
Management of denials.
Reduction of the credit balance.
Services We offer
Emerald Med Solution can provide insurance credentialing services for private and public insurance providers such as Medicare, Medicaid, Aetna, UPMC Health Plan, Anthem, Blue Cross Blue Shield, Tricare, Cigna, and others.
Investigation
Detailed pre-call investigation using system notes and EOBs.
Prioritization
Prioritization and allocation of work based on factors such as payer categorization, claim value, and claim age.
Professional Team
Dedicated professional team that monitors the collection procedure.
Reporting
Ad-hoc reporting, A/R analytics, and dashboards for denials are all used.
Research
Fundamental research on denial causes and tendencies.
Pertinent Answers
Reengineering while also offering pertinent answers for a healthy A/R.
Denial Management
In the healthcare sector, the typical claim denial rate is from 5% to 10%. Most providers view these rejected claims as a waste of resources and a blow to their bottom line. However, many providers are unaware of how important that impact is. Despite the fact that 63% of denied claims are recoverable, data suggests that 90% of denied claims are avoidable and that up to 65% of denied claims are never resubmitted. This sum of money was left unclaimed. Your organization may boost payment recovery with the support of our successful denial prevention strategy and committed denials team. This is accomplished by figuring out why a claim was denied in the first place, rewriting the denial, writing appeals if necessary, and resubmitting the claim.
Denial Management Services We Provide:
Locating and addressing the sources of denials
Getting in touch with payers and patients to collect more data
Composing appeals, amending claim data, and resubmitting updated claims
The advantages of our services for account receivable and denial management
Our adaptable solutions are made to monitor important KPIs, enhance clean claim rates, and streamline your A/R and rejection management procedures. In other words, you can rely on us to turn your receivables into money.
Timely reimbursements
Reduced denial rate
Reduced A/R days
Operational efficiencies
Sustained cash flow
Low cost to collect
Quick turnaround time
Access to skilled and experienced resources
Cost-effective solutions
Customized reports
Claims handled for all payers
Updated on industry regulations
Analytics through Emerald Med Solution
The business of its clients has been transformed by technology thanks to the adoption and use of cutting-edge technology by ABC over the years. U-Track, a performance monitoring and workflow management system created internally by the 3Gen software team, is one such instance.
#01
Oversees the everyday workflow.
#02
Creates management reports that are personalized.
#03
Monitors each resource's daily output and turnaround time.
#04
Monitors volume and aids in managing/allocating records with higher maturity dates and priorities.
#05
Provides a management dashboard with real-time data on the daily volumes the customer has assigned and the work the 3Gen team has performed.