Case Study

How QWay Healthcare Helped Reducing Denial Rates of Claims?

Problem Statement

The client, a mid-sized healthcare facility, was grappling with a high denial rate for their insurance claims. Despite their best efforts, a substantial percentage of claims were being rejected or denied by insurance payers. This situation not only hampered the facility’s revenue stream but also put a strain on their administrative resources.


QWay Healthcare conducted a thorough assessment of the client’s RCM processes and identified key findings:

  • Data Analysis: A significant portion of denials were attributed to incorrect patient information, coding errors, and missing documentation.
  • Lack of Automation: Manual data entry and claim submission processes were prone to errors and inefficiencies.
  • Limited Denial Insights: The client lacked a robust system to track and analyze denial patterns, hindering the ability to make informed decisions.