Denial Management

Denial management is a vital component in the medical billing process. Denial management in medical billing is to investigate every unpaid claim and appeal the rejected claims. It demands extensive knowledge and timely execution. Meridian have a well-experienced team of denial management professionals trained to identify the root cause of expensive denials. Meridian can handle denial efficiently and in a timely manner to minimize denials reimbursements. Meridian corrects and resubmits the claims and files an appeal towards deemed medically not necessary claims. The appeal letter is sent to retreat the payer for their mistakes and make them clarify why the original processing of the claim was incorrect. Systematic tracking of denials will collect data back to the billing process to prevent future denials of the same nature, thus ensuring first submission acceptance and payment of claims. The Denial Management team helps you to take control of your denials and accelerate reimbursements.

Denials occur because of

  1. Inaccurate or Incomplete
  2. Insurance information
  3. Absence of Pre-Authorization number
  4. Filing claims after the allowed time frame
  5. Credentialing and non-enrollment errors of the provider
  6. Medically necessity of patient

What our denial professionals do

  1. Examining the volume of denials and analyse them
  2. Reckon denials not meeting the deadlines and claim age
  3. Statistically estimating denials based on payers, CPT codes and ICD 10 standards/HIPAA regulations
  4. Grouping the denials by coding and CPT/HCPCS
  5. Preparation of a comprehensive denial management report
  6. Systematic approach of tracking and managing claims denials
  7. Reduce denial backlogs and apply best practices to reduce denials overtime
  8. Work with payers to revise or eliminate contract requirements that lead to denials and appeal
  9. Prevent future claims denial by reconciling missing patient information with existing records
  10. Denied claims are appealed to reverse the payer decision such as fee schedule, no pre-authorization & pre-cert (extenuating circumstances), filing time limit, Medically necessity denial, etc
  11. Focus on appealing claims that bring the highest amount of revenue than the provider adjustment
  12. Claims-related alerts activation to inform particular denials. Creating awareness to the health care providers by sharing information about unpaid denial issues