Denial Management Services

We specialize in providing denial management solutions for claims that have a 'reject/resubmit' status and have aged beyond 60 - 90 days, yet are not yet ready to be assigned to collections. We firmly believe in the significant value of pursuing these types of claims on behalf of your healthcare facility, especially in light of resource limitations that can hinder your facility from processing these claims with the same timeliness as newer ones. Despite timely payment rules in many states, a common challenge faced by hospitals is the difficulty in collecting accounts that are 60 to 90 days old. Processing such claims can often be a challenging task for many hospitals. Our ultimate goal is to alleviate the burden of un-collectible accounts on your facility's financial health while offering expert medical billing audit services.

Explore ClaimsMed's Offerings

WHAT SERVICES CLAIMSMED PROVIDES?

Denial Analysis

​At Claims Med, we have a complete solution for denial analysis and for their follow-ups.

Insurance Follow-Up​​

We run aging reports to categorize (Oldest to Largest and highest to Lowest)  claims 

Patient Follow-Up​​

​At Claims Med, we follow up with the Patients to clear the outstanding payments.​

Benefits

• ​An alternative to immediate collection agency placement.
• We successfully secure full benefits of claims previously denied.
• The provider can maintain good patient/provider relations with each other.

Medical Billers

• ​Submission of medical or operative records.
• Patient completion of coordination of benefits or other forms.
• Correction of improper billing information.
• ​Re-submission to the proper carrier.
  

Two-pronged strategy 

• The first critical aspect is to proactively follow up on denied or rejected claims or requests out to relevant parties.
•  Denial or rejection details are gathered, it's important to analyze and identify the specific reasons for denial.

Overview

Follow Ups

We specialize in pre-collections follow-up for claims that carry a 'reject/resubmit' status and have aged beyond 60 - 90 days, making them ineligible for immediate assignment to collections. At CLAIMS MED, we firmly believe in the substantial value of pursuing these types of claims on behalf of your healthcare facility. This becomes even more critical in light of resource limitations that can impede your facility's ability to process these claims with the same timeliness as newer ones. While many states have stringent rules for timely payments, a universal challenge for hospitals remains the difficulty in collecting accounts that have matured to the 60 to 90-day mark. Reprocessing such claims often poses a significant challenge. Our core mission is to alleviate the burden of un-collectible accounts on your facility's financial health through our expertise in medical billing audit and denial management services.

​We track denials, log what has been denied, why, how, and when the claim was filed to the greater levels
of details.

• Pre-adjudication (accepted/rejected claim status)
• Claim pended for development (incorrect/incomplete claim(s) within adjudication process) or suspended claim(s) requesting additional information
• Finalized claims. Further defined, finalized claims may have outcomes that include finalized rejected claim(s), finalized denied claim(s), etc.

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