Denial management is what healthcare billing deals with. Though complex, denial would befall healthcare billing even for the unlikeliest of reasons, such as documentation, error in coding, or the patient not being eligible for the service. It impacts the revenue cycle and even cash flow. Proper denial management is necessary to keep services running smoothly and avoid any loss of revenue. Therefore, Unify Healthcare Services provides its patient-care-focused healthcare providers with complete denials management, from the analysis to reducing rejections and, hence increasing revenue flow, thus securing the financial position of healthcare providers while healing patients.

What are Claims Denials?

Claims denials may be defined as when the insurance company refuses to make any reimbursement to the healthcare provider for services provided. These denials can stem from various sources, including wrong or missing patient information, coding issues, and not having prior authorization. In addition, there are also instances when deadlines have been missed. Sadly, handling these denials gobbles up much time and money for a healthcare organization, especially for hospitals that process thousands of claims every day. Otherwise, without the right approach, denials will convert into lost revenues and administrative expenses that are higher than they have to be.

We understand, at Unify Healthcare Services, that denial management forms a significant component of the maintenance of a healthy revenue cycle. Together with the healthcare providers, our experts analyze and engage to combat and avert denials of claims hitting in such a way that brings the payment process to completion without disruptions to revenue streams.

The Denials Management Process at Unify Healthcare Services

Effective denials management requires a multi-step approach toward identification, rectification, and prevention of denials. Being system-based, Unify Healthcare Services enables hospitals and medical practices to optimize billing procedures and recover lost revenue as follows:

Denial Identification:

Identify denial causes. Looking through the denied claim in its entirety allows Unify Healthcare Services to know whether the denial is indeed due to coding errors or missing documentation, among administratively related causes. Knowing the reason will enable Unify Healthcare Services to devise proper strategies on how to remedy and resolve each denial effectively.

Our staff, once denial causes are determined, then work to correct errors or omissions in claims. We allow corrections to become efficient and swift, whether that is re-submitting documentation; coding errors, or further information requested by the patients, ensuring timely reimbursements. With a proactive approach, we will ensure our claims will be reprocessed the first time, preventing delaying or rejecting subsequent claims.

Appeals and Follow-up:

In case of wrongly denied claims, Unify Healthcare Services automatically institutes an appeal process, directly communicating and working with the payer for reimbursement. Our team handles all communications and necessary follow-up documentation in the appeal process for efficient processing. In the process of managing denials, persistence is essential, and we make sure no potential reimbursement goes back on the table.

Prevention and Continuous Improvement:

One of the most significant dimensions in denials management is being able to prevent such occurrences from happening in the future. Analyzing claim trends and identifying causes in common denials will enable us to assist hospitals and practices in implementing preventive measures that may take the form of improving coding accuracy, streamlining documentation procedures, and ensuring payer requirements are followed while submitting claims. This way, over the long term, we can minimize the loss in revenue for healthcare providers.

Why Outsource Hospital Billing Services for Denials Management?

Managing denials in-house can be a particularly challenging task, especially for hospitals already bombarded by the complexities of billing and administrative work. By outsourcing your hospital billing services with a specialty provider such as Unify Healthcare Services, you can realize numerous advantages that strengthen your revenue cycle and, ultimately, drive better financial performance.

Healthcare billing and insurance requirements and coding standards are highly specialized knowledge in handling denials; therefore, Unify Healthcare Services uses a team of experts to handle all various types of denial scenarios. This way, there will be an effective review of denials, claims corrected fast and resubmitted very quickly to avoid delays in payments.

Less Administrative Work

Hospital billing services outsourcing will shift the unproductive task of denial handling to a well-trained professional team. This allows the optimum utilization of internal resources that help the staff to concentrate on more vital areas of patient care and operational efficiency.

Improved Cash Flow:

Denied claims can be a huge cash-flow burden to a hospital, which might have to bear immense financial pressure. Outsourcing management of such denials will enable one to recover the lost revenues promptly and ensure that reimbursements keep coming in at regular intervals. Unify Healthcare Services specializes in quick resolution of denial, ensuring that providers can run their finances smoothly.

Proactive Denial Prevention:

Advanced analytics and reporting tools enable hospitals to gain insight into the denial patterns and take preventive actions without potential future denials. This will ensure that the hospitals settle both pending and recurring denials, which also enhances their billing processes.

Benefits of Selecting Unify Healthcare Services

Unify Healthcare Services will focus to help healthcare providers improve their financial performance through expert denials management, among other outsourced hospital billing services. Our solution is uniquely fitted to the challenges specific to hospitals and medical practices, given the company's experience in revenue recovery and effectiveness in billing processes.

• Customized Denials Management Solutions: We understand that no two healthcare providers are alike, and so we design customized solutions perfectly tailored to your requirements and objectives.
• Industry Expertise: As a leader in healthcare billing for almost two decades, Unify Healthcare Services comes with the years of experience and expertise required to deal with the toughest billing challenges on your desk.
• Continuously support and advise: Our team will be in place for continuing support, providing insights as well as recommendations to optimize the revenue cycle while trying to stay ahead of potential denial issues.