AR Follow-up and Denial Management

Are you concerned about revenue dropping? Are you understaffed? Are your AR days increasing? Do you have backlogs that won’t go away?

Your staff is focused on generating clean claims and ensuring that they are processed in a timely manner. The challenge you face: Who is following up on the denied and unpaid claims? Who is responsible for your daily rejections? Are they able to make these responsibilities a top priority? Billing claims is what your staff does best. Reviewing each claim thoroughly and working with the insurance company to make sure that the maximum amount is paid for your claims is what we do best.

AnnexMed insurance follow-up services are designed to focus on increasing cash flow, lowering adjustments and reducing the number of days in accounts receivable. We provide aggressive follow-up with the insurance companies on all accounts at any stage of the aging bucket. Using a systematic approach for each claim, we identify problem accounts, obtain any information needed for processing, and streamline the entire insurance reimbursement process. So your business will have access to this revenue more quickly and efficiently. Each agent will make at least 60–80 telephone calls to insurance companies each day. But it’s not just getting them on the phone—it’s convincing them to take action. We have an extremely effective call structure with highly trained professionals who can make a difference in your outstanding receivables immediately.

Denial Management

Nothing is more critical to revenue cycle profitability than to have highly efficient claims denial management processes in place. The typical organization can easily experience initial denial rates of 7-10% of its claims. A common best-practice recommendation is to hold the initial denial rate to 4% or less. For many practices, even that level of revenue exposure can mean the difference between operating at a loss and staying in the black.

The rapid growth in managed care has sparked a staggering increase in denials, with payers denying 15-20% of provider charges. Plus, ICD-10 implementation will entail a 700% increase in procedure and diagnostic codes. AnnexMed’s Denials Management process is designed to review every single denial to uncover the causes leading to the denials. We analyze, track, trend and report on denials, identifying unpublished rules and recommending fixes for individual denied claims while helping you identify and implement process improvements to eliminate recurring denials and optimize revenue. We have established a reputation for helping practices/organizations enhance their collections through proven denials management techniques that ensure payment of every dollar earned. Healthcare service providers are referred to AnnexMed because of our ability to produce consistently superior results. However, what truly sets us apart from the competition are the trusted relationships that invariably evolve between our clients and the AnnexMed team.

Service line deliverables:

  • Denial assessment
  • Root cause analysis
  • Clinical and technical appeals
  • Comprehensive management reporting
  • Payer behaviors trended to increase contract negotiating power