| Are you experiencing these symptoms?
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No prior approval |
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Undocumented medical necessity |
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Denied level of care |
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Denied end of stay days |
Recent industry studies indicate that 10% to 15% of a hospital’s
managed care claims result in full or partial medical denials.
Our experience indicates that 67% of these medical denials
can be recovered through the filing of effective appeals.
And, with the information developed through the preparation
and filing of these successful appeals, you can significantly
reduce future medical denial rates.
You are already aware of the reasons for medical denials.
You also know that the recovery process is resource intensive,
requiring a thorough understanding of the payor’s authorization
and appeal processes and clinical guidelines. And you understand
that successful appeals require time and resources –
especially clinical staff.
Too often a hospital’s business office personnel are
already dealing with more complexity than they can efficiently
handle. They don’t have the medical expertise needed
to interpret medical records or establish medical necessity,
and the addition of clinical resources may not be feasible.
Your clinical personnel are busy with patient care and are
often unable to devote time to support the business office
in developing medical appeals. Unfortunately this results
in failed appeals, unnecessary managed care write-offs and
lost revenue. This is specifically where Chapin Revenue Cycle
Management can help.
Confronting
Denials Head On
Let us help you recover what's missing from your bottom line.
For further information about Chapin's customized solutions,
contact us ().
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