INSURANCE CLAIMS DENIAL MANAGEMENT & APPEALS
At CareMed Partners, we take a big-picture approach toward medical claim denials. We investigate all unpaid claims for our clients, looking for trends that can help us fix and re-file claims, or appeal and reverse denials.
Because of our extensive experience with denial management and appeals, the process is smoother and less costly or burdensome than you might expect. With CareMed, you get professionals with specialized skills who use their decades of expertise along with proprietary audit software to hone in on the precise key to getting you the reimbursement you’ve earned.
The sad truth is that even when an insurer incorrectly denies a medical claim, the burden is on the physician to prove it. This is why savvy healthcare providers outsource with revenue cycle management specialists who are experienced in claims denial management and timely appeals.
Why Medical Claim Denials Can Be So Confounding
Denial codes can be vague and confusing. Sometimes – and this is the real wake-up call for many of our physician clients – the code used is barely related to the real reason the claim was rejected. At CareMed, we thoroughly analyze the situation, using the tools at our disposal, to identify the underlying cause of denial as well as the coded reason.
Claims may be denied for a number of reasons, including:
- Claim contains missing or incorrect information, such as accurate patient demographics or proper medical codes
- Improper or skipped insurance verification
- The insurer misunderstood or misclassified the information on the claim
- The insurer incorrectly applied its rules
- Late filing
- Lack of physician referral or pre-authorization on file
Stop living with repeated claim denials. No healthcare provider can afford the write-offs and lost revenue these payer denials can result in.
Turn Medical Claim Denials Into Increased Cash Flow
Sometimes, all that stands between you recouping thousands in already-delivered services is an audit of insurer denials with denial management specialists at CareMed. We can help you reduce the number of claim denials you receive – boosting your bottom line in the process.
Tracking claim denials and underpayments can also help identify administrative policies and procedures in your office that require updates or improvements to prevent future medical claim denials.
Our friendly staff is available to help address any questions or concerns you have about our denial management and appeals services. Want to know more? Just ask! Call CareMed Partners today at (877) 271-2645 and start getting the medical billing help you need.
Contact Our Medical Billing Specialists Today!
Denial management and appeals is just one of our many revenue cycle management services. Find out more about the next step in the cycle: patient statements and follow-up.