Hospitals often experience insurance payment delays and/or denials from third party insurance payers causing significant delays in cash flow and reimbursement losses. Unfortunately, many of these delays and denials are unwarranted based upon the applicable terms of your provider agreement or are unnecessary due to deficiencies created during the patient intake and billing processes. These types of accounts can be very complicated and time consuming for the in-house staff to address without falling behind on their daily account work queues.
Audley Law utilizes proprietary claims dispute analysis software as well as 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 the account, dollar value, etc. Once these account qualifiers have been discussed and confirmed, ALO will directly participate with the organization in setting an automated monthly referral 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. Your in-house staff will have more time to address their daily work queues; related write-offs will drop and cash flow will improve!