Solution Bundle

Denials and Appeals Management

Outsourced denials and appeals management services for hospitals that want to improve their clean-claims rate, better manage denied claims, and have expert assistance in handling appeals.

 

Get Support
Contact Sales

MinimizeMedical Billing Denials

  • Identify and correct root causes of denials to improve your clean-claims rate.
  • Reduce your cost of managing denied claims and the administrative burden on staff.
  • Rely on our expertise to resolve underpayments.
  • Streamline workflows for greater efficiency, faster appeals, and improved cash flow.
  • Help reduce regulatory risk with improved compliance.
  • Help improve revenue cycle management and financial performance.

Improve Your Denial Management Workflow

  • Denials and appeals management services

    • Access our expertise in analyzing payer adjustment codes from remittance advice, including case management and utilization review, to facilitate successful appeal of denied claims.
    • Enable our skilled, experienced staff to advocate on your behalf with payers; we help to quickly resolve underpayments related to interpretations of contract, policy, or documentation.
    • Benefit from our custom-created ‘Gold Standard’ compliance program which exceeds all requirements of the Office of Inspector General.
    • Our clinical and technical experts include skilled nurses and revenue cycle experts, and because our services are system-agnostic, these staff can work onsite or remotely within your existing billing system and EHRs.

  • Payer audit services

    • Leverage our expertise in appealing Medicare notifications to rescind payments via the Medicare Recovery Audit Contract Program (RAC), and to address other commercial and government payer audits.
    • Rely on our team to coordinate medical chart reviews and meet appeals deadlines, alleviating the administrative drain on your staff in patient financial services, case management, and health information management.

  • Ongoing system edit-and-workflow maintenance

    • Depend on our experts to keep your team abreast of regulatory changes. We review and implement payer bulletins and educate your staff via tutorials—all to facilitate a proactive approach to denials management.
    • Engage our team to provide ongoing edits maintenance, workflow modifications, and system cleansing to help ensure your claims submissions reflect payer compliance updates and regulatory changes.

  • Detailed denials management process reporting

    • Gain valuable trending insights as well as specific recommendations for documentation, edit improvements, claims management, and process improvements to address the root causes of denials and to increase clean claims.
    • Leverage our detailed reports on denials and underpayments during payer contract negotiations.

Our outcomes

View all insights

Fact Sheet

Healthcare Communications for Providers

Fact Sheet

Healthcare Communications for Providers

Leverage our deep experience in healthcare communications for providers and support cash flow, increase speed to payment, and contain costs.

Learn More

Infographic

Inventory Management Solutions Made Simple

Infographic

Inventory Management Solutions Made Simple

Discover inventory management solutions that guide the decision-making process for efficiency gains, better practices, cost savings, and safer care delivery.

Learn More

e-Book

Humanizing RCM

e-Book

Humanizing RCM

Discover how humanizing the revenue cycle throughout a patient’s financial journey will help to elevate providers in an increasingly competitive landscape.

Learn More

PRODUCT SUPPORT

Need support for
this solution?

Get support
Explore related solutions

Let’s start a conversation

We’re here to help you find out how this solution could benefit your organisation. Complete the quick form to the right, and someone will reach out to you soon.

Our experts will:

  • Discuss your individual use case and business needs
  • Explain our features, benefits, and services
  • Show how this solution can help achieve your goals

Want more information? Start here.

Thank You

We appreciate your interest in Change Healthcare. A member of our team will contact you to better understand your needs and discuss potential solutions.

Together, we are accelerating the journey toward improved lives and healthier communities.