ARE YOU GETTING TO THE

ROOT CAUSE OF YOUR DENIALS?

MEDICAL BILLING DENIALS ARE AVOIDABLE

Denied claims are a daily norm. We fix and manage them within our A/R management efforts, make notes and then move on to the next round of denials/correspondence. Most health information systems today aren’t designed to review collective data from a historical viewpoint. Therefore, we typically treat each denial as a single error instance and “learn” how to alter our revenue cycle efforts to prevent mistakes from occurring again in the future.

Top Denial Reasons

  • Bundled services

  • Coding errors

  • Registration errors

  • Duplicate claims

  • Expired time limits

  • Non-Covered services

NUMBERS TELL THE STORY

The industry benchmark for medical billing denials is 2% for hospitals.

In medical practices, medical billing denials range from 5-10%, with better performers averaging 4%.

Some organizations see denial rates on first billing as high as 15-20%.

For those providers one out of every five claims needs to be reworked or appealed. Rework costs on average $25 per claim and success rates vary from 55-98% depending on the medical denial teams capabilities.

HERE’S HOW WE’LL HELP

Analyzing the cause and finding inaccuracies before claims are remitted helps protect revenue. Preventing those mistakes is an even better, more efficient strategy. Our main approach is to conduct a root cause analysis, determine the origin of error, correct existing issues, and prevent a repeat error.

WE’LL WORK WITH YOU TO:

Quantify and categorize denials

Create a task force

Improve patient data quality

Avoid incorrect assumptions and determine true reasons for denials

Develop a denials prevention mindset in all parts of the revenue cycle

Quantify and categorize denials

Create a task force

Improve patient data quality

Avoid incorrect assumptions and determine true reasons for denials

Develop a denials prevention mindset in all parts of the revenue cycle

Contact Us Today

david@epilogworks.com | 407.417.7337

About Epilog Solutions

Epilog Solutions assists healthcare providers by identifying and solving the challenges that naturally exist within the revenue cycle. We partner with healthcare providers so their organization can offer the best care with optimal cash flow. By discovering, clarifying and solving challenges within the revenue cycle, Epilog Solutions bridges the gap for healthcare providers to maximize their available resources.