Denial Management
Services

Given the industry-wide prediction of decreased revenue in the coming years, it is imperative for healthcare organizations to understand, quantify, and address the root cause of their
current claim denials and establish a solid denial management process.

Atom Healthcare deploys a focused team of denial management professionals who work with you to minimize lost reimbursements. We investigate the reason for every denied claim, resolves the issue, resubmit the claims, and follow-up to effectively shorten the A/R cycle. We correct invalid or incorrect medical codes, provide supporting documentation, understand non-covered medical conditions or prior authorization issues, and patient/insurance information prior to re-submission.

Our team will reduce your denial backlog and apply best practices to reduce denial percentage over time. Through our expertise in working with multiple healthcare providers, we have developed best practice appeal strategies to improve recoveries.   

APPEALS FOR DENIED CLAIMS

We prepare appeal letters, attach supporting documents including clical documentation that are required for denials to be reprocessed by the payers. The documentation is submitted via fax appeals in payer specific formats.

DENIAL PREVENTION THROUGH ANALYTICS

Shift focus to preventing denials with Atom Healthcare. We look at denial trends and understand the reason for denials- billing, registration, medical coding, clinical documentation issues- that are recurring. We work with revenue cycle team members and the provider staff to systematically address the issues to prevent denials.

Atom Healthcare accelerates the repair and re-submission of denied claims for cross-departmental teams for your organization.
An intelligent workflow engine applies client-specific logic to efficiently distribute denied claims requiring re-submission to the right departments and individual team members, and maintains a detailed history of actions on all claims.

BENEFITS

Atom Healthcare provides exceptional A/R Management services through diligent follow-up, denials and appeals management, patient-centric account resolution, and A/R analytics.  Benefits include:

  • Focused approach to increase resolution

  • Reduce your administrative and clinical claim denial backlog through a dedicated team

  • Apply best practices that will reduce denial rates over the long term

  • Dashboard and metrics to improve collections.

  • Timely follow-up and submission of claims to avoid timely filing issues

  • Workflow to optimize employee utilization

  • Guaranteed performance metrics

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