10% - 15%
Denials Cost Money
One in three healthcare executives say that denied claims happen about 10%-15% of the time, resulting in billions of dollars in lost revenue. Utilizing our automated insurance verification process can reduce or eliminate these denials.
30%
Insurance Verification
Recent Studies show that healthcare providers spent an average of 30% of their annual income in the insurance verification process. Utilizing the right insurance verification software will help minimize these costs.
80%
No Prior Auth
Around 80% of claims are denied due to no prior authorization being obtained from the carrier — a key part of the revenue cycle. We make this critical step cost-effective to reduce or eliminate these types of denials.
We fix documentation and coding errors
Documentation and coding errors remain primary contributors to claim denials. Audits performed in 2023 revealed that 56% of coders failed to properly code the medical claims investigated in those audits.
Emerging Claim Denial Trends
- Use of artificial intelligence (AI) with dirty data
- Prior authorization challenges
- High-cost claim denials
- Compliance with regulatory changes
- Documentation and coding errors
Overturning and correcting denials is possible but comes with the high cost of rework and shifting resources away from other critical areas. Technology can help increase your first pass rate, however. To reduce denials and eliminate data issues, it is critical that we understand your business and the issues that are plaguing your organization. Our expertise and technology solutions help you implement a successful strategy and avoid unnecessary denials.
Our Services
We solve often hard to identify data accuracy and consistency issues within your healthcare system. Your focus should be on your patients and your practice, not fixing data issues and dealing with the frustrations of inaccurate billing for the valuable services you provide.
Data Quality & Validation
The source of most revenue problems for a medical practice is data quality. We help you understand and correct data within your system that leads to better medical coding and billing for the services you provide.
Data Privacy & Security
Data theft and exploitation is on the rise. Foreign actors are targeting the healthcare industry in increasing numbers. We can help identify ways to make your systems more secure and prevent data loss from breaches of security.
Consultation & Training
Fixing your data and your system is often not enough. Proper maintenance is critical to keep your healthcare system functioning optimally and accurately. We'll show you how and train your staff to make this an effortless endeavour.
Our Process
Initial Consultation
Identify problem areas for your business and revenue generation
Data Analysis
Analyze system configuration, billing & coding practices and staff procedures
Proposal for Correction
Presentation of steps for corrective action to increase data accuracy and efficiency of your practice
Implementation
Correction of system issues and training of personnel to optimize your business
Industry News
Commercial Denial Statistics
A new study released by Crowe Revenue Cycle Analytics suggests that commercial payers have increased denial claims over the past three years, according to HealthLeaders.
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Insurance Verification
Health insurance verification is one of the key initial steps in the revenue cycle. Any errors present during insurance verification can have adverse effects on billing revenue.
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Claims: Rejections and Denials
It is estimated that around 80% of claims are denied due to no prior authorization being obtained from the carrier — a key part of the revenue cycle and insurance eligibility verification process.
Read moreSchedule a Free, No-Obligation Consultation
We'll spend some time getting to know you and your business so we understand the areas where we can assist