Denial Management Services

​At Claims Med, we find that to ensure efficient revenue cycle denial elimination through proper denial management is imperative. In the health care industry payers often find reasons to underpay, deny or delay payments. Not only do we appeal denials but we also track and analyze patterns that lead to this problem so that it can be addressed early on. The procedures and processes that we have in place ensure maximum reimbursement to your practice.

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 for 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.

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 do pre-collections follow up for claims which have "reject/resubmit" status and have aged beyond 60 - 90 days and are not ready to be assigned to collections. We believe that there is significant value in pursuing these types of claims on behalf of your healthcare facility, particularly in the wake of resource limitations that can prohibit your facility from processing these claims with the same timeliness as the newer claims.In spite of timely payment rules in many states, a common complaint of all hospitals is difficulty in collecting accounts, which are 60 to 90 days old. Many hospitals have a difficult time reprocessing such claims.Our goal is to lessen the burden of un-collectible accounts on your facility's financial health.

​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.

Re-filing of Claims

Reviewing the reasons for denial, making necessary changes, and resubmitting the bills.
For more details please call us at (713) 893-4773 or send us an email at info@claimsmedinc.com.