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.
FINDINGS
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.
