Denial Management
Ghafoor Ahmad
Healthtech & Fintech Entrepreneur | Co-Founder & Global Chief Revenue Officer at KLAIM.ai (Techstars '21) | Founder & CEO of A G A Healthcare Revenue Cycle Management (RCM) | Driving Innovation in Healthcare Payments.
Denials can have an adverse effect on your cash-flow. Managing denials promptly and effectively will result in an increase in the cash flow and enhance the effectiveness of the billing process. With the help of effective denial management services to handle your claims, AGA can prevent most of the denials and therefore, recover your revenue for you Denial rates vary widely depending on physician specialty. You need to look at denial rates by type of specialty because a denial rate of 15 percent affects practice profitability. When the denial rate is high, it should be looked at immediately. why they are happening and preventing them. Our expert claims management AGA team works towards re-submitting your denied claims and getting them processed, analyzed, corrected, and updated.
Denials occur due to
- Inaccurate or Incomplete Insurance information.
- CPT codes or modifiers are not put in the category.
- Credentialing Errors or no enrollment of the provider.
- Pt. names are spelled incorrectly or don’t match with the patient’s insurance card.
We drive up your cash flow & overcome the denials by
- Analyzing the volume of the denials by a thorough study of your claims.
- Prompt follow up on the denied claim and resubmit claims, calling the insurance company and finding out the denial reason.
- Evaluating denials with respect to age, claim expiration, fail to meet the deadlines.
- identify the denials based on payers, providers, CPT codes, and general non-compliance to the ICD 10 standards.
- prepare a comprehensive denial management report.
- This systematic approach helps in successfully tracking and handling claim denials.