What is Denials Management?

1
What is Denials Management?
2
(No Transcript)
3
Denials Management

• Denial Management in Medical billing services is
  the most arduous process and is often overlooked
  by physicians and medical practices due to their
  busy schedules and primary focus on patient care
  eventually, the claim denials get accumulated
  causing distress to the entire process and
  financial grounds of the medical practice if not
  taken care on time.
• Therefore it is essential for every medical
  practice to have a proper denial management
  system in place to protect their claims quality
  and revenue.

4

• Denial Management is not only about working on
  the denied claims but also about creating a
  smooth working process by improving process
  quality, focusing efforts towards uncollected
  revenue and maximizing the collection, and also
  preventing and lowering denial percentage by
  identifying repeated denial reasons and educating
  respective claims processing team to get them
  corrected.
• With MGSI as your Medical Billing and Denial
  Management Partner, you can experience the
  difference and witness increased collections and
  improved claim quality.

5
Denial Management Process in MGSI

• Claims denials occur for various reasons, while
  the focus should be on reducing the denial
  percentage by increased first pass ratio denials
  cannot be ignored completely as claim denials are
  inevitable which necessitates the need for an
  efficient and timely Denial Management process.
• The denial management team should be experienced
  enough to identify the cause of claim denial and
  rework within the turn-around time (TAT) to get
  them processed successfully and profitably.

6
Denial Management Process

• The first and foremost step towards denial
  management is to identify claim denials. The
  proper and efficient claims tracking system is
  mandatory to ensure the claim denials are
  identified and re-processed.
• After Identifying claim denials, it is the
  responsibility of the denial management team to
  do a complete analysis of the claim to identify
  the reason for claim denial and fix them to
  re-submit the claim again with the insurance
  company

7

• Appeals are part of the denial management process
  where the denial management team needs to provide
  supporting document to justify for their appeal
  and follow up to get the reimbursement.
• Constant follow-up with insurance companies is
  necessary to ensure the appeals are processed in
  a timely manner
• Denial management team also helps prevent claim
  denials by educating the medical billing and
  coding team with their findings on denial reason
  and thereby helping cleaner claims to be
  processed.

8
About MGSI

• MGSI has been serving over 600 physicians across
  the nation with complete Revenue Cycle Management
  Services for various specialties and has been the
  forerunner in the industry by providing Medical
  billing services for over 29 years.
• Leveraging our Denial management expertise can
  bring positive impact to your practice and
  monthly revenue.

9
Contact us

• Call us 1 877-896-6474
• Email us info_at_mgsionline.com
• Visit us www.mgsionline.com
• Thank You!