Hospitals often experience insurance payment delays and/or denials from third party insurance payers causing the provider to file endless insurance appeals and make numerous attempts to contact the patient for additional information. Unfortunately many of these cases end up placed with a third party debt collection agency or are deemed uncollectible by the provider and written off.
We utilizes proprietary claims dispute analysis software as well an experienced team of professionals who possess an in depth knowledge of the governing healthcare payment statutes and regulations, including the ACA,ERISA, Medicare and Medical Assistance and Veteran’s Administration matters. Our staff will review payment denials and related insurance correspondence to ensure compliance with the law and the terms of your provider services agreement.
We will work with your organization to establish the account selection criteria for these at-risk accounts, including applicable payers, age of account, dollar value, etc. Once these account qualifiers have been discussed and confirmed, we will directly participate with organization to create an initial detailed account file for further in-depth review and appropriate action. Also, an automated monthly referral process can be established to ensure timely and effective resolution of all future accounts.
You will have assured confidence that these types of accounts will be identified in a timely fashion and worked in an effective manner by our experienced professionals to reduce your bad debt. Our analysis affords your facility the opportunity for a second review of uncollected accounts to ensure all monies due your facility are realized.