Denial Management and Rejection Handling

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Denials can have an adverse effect on your cash flow and every year billions of denials are left unresolved due to inefficient processes and teams. Handling denials promptly and effectively will result in an increase in the cash flow and enhance the effectiveness of the billing process by applying billing instructions in order to stop recurring denials for future submissions. QWay’s Denial Management Program addresses both historical and future claims with the ability to recover otherwise lost revenue. We try to fix any problems that are discovered in the claims that were denied. To eliminate any inconsistencies, we meticulously examine all claims while processing through the Medicaid and Medicare Services' requirements. Some claims are rejected because they need to be better formatted and contain the minimum amount of information, while others are affected with coverage or contract issues.

Our teams are well versed in researching and implementing insurance guidelines for CPT and ICD codes and in fixing the denials past visits and implementing the billing instructions for the future claim submissions.

QWay Strategies To Reduce Denials

  • Analyze the volume of the denials and baseline analysis
  • Closely work with insurance providers and remain updated with latest norms and procedures
  • Evaluate denials with respect to age, claim expiration, and non-meeting of deadlines
  • Statistically estimate the denials based on payers, providers, CPT codes and general non-compliance to the ICD 10 standards.
  • Recurring Analysis for new trend specific to contract, enrollment, and coding part

Denials Management Process:

  • Determination of the causes leading to claim denial.
  • Investigating rejected or unpaid claims.
  • Observing or tracking general reasons behind denial not just with one but multiple health insurance providers
  • Appealing for denials as per the process
Why choose Qway for Denial Management services?

The Denial Management process at Qway is carried out with data and trend analysis – the key to the success of the process. Our systematic way of tracking denials gets information back to the billing process to prevent future denials of the same nature.

We drive up your cash flow and reduce the flood of clinical denials restraining from a major impact on the growth and profitability of your organization. Outsourcing denial management services with Qway will aid you in facing the challenges of staff shortages and training costs as we employ the best heads for your pain points with problem solving abilities and efficient work processes. We offer your organization the required expertise, organizational workflow protocols, and resources for a comprehensive process set-up and execution.

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