Category Archives: Denial Management

Press Release – Bristol Healthcare Assists Providers and Hospitals to Bill for Nearly a Million Covid-19 Vaccine Doses

Press Release on “ Bristol Healthcare assists providers/hospitals to bill for nearly a million Covid-19 vaccine doses” was published in on 14 December 2021.

Cerritos, California Dec 14, 2021 (  – Bristol Healthcare Services, a medical billing and coding company located in Los Angeles, California, is pleased to announce that as of the end of last month, the company has assisted healthcare providers and hospitals to bill for nearly a million administered COVID-19 vaccine doses.


Why is Pre-Authorization Vital in Medical Billing Management?

Health insurance needs to be checked for pre-authorization requirement

What is pre-authorization?

Pre-authorization is the procedure of obtaining prior approval from payors before medical services are rendered to patients. It indicates that the payor confirms the medical necessity of the service, treatment plan, prescription drug, or durable medical equipment being offered/prescribed. (more…)

Clean-up Aging Accounts Receivable (AR) Using Onshore and Offshore Resources

Managing Accounts Receivable is a vital healthcare service

What is Accounts Receivable in Healthcare RCM?

Managing Accounts Receivable (AR) and a healthy cash flow is a major challenge for every healthcare professional and facility. In the healthcare industry, AR represents the amount that is due from insurance companies and patients.

To understand the AR status of a practice, “Days in AR “is computed, which is the average number of days it takes to collect payments that are due to the practice. The AR is then classified into buckets such as 0-30 days, 31-60 days, 61-90 days and so on separately for patients and payors. The aging AR bucket data indicates the performance of the billing department. (more…)

Effective Denial Management with Rigorously Tested Strategies

Denial management discussion

Denial Management is vital to your practice

Denial of claims is a source of stress and a drain on the revenues of a practice. Therefore, denial management is a vital component of the Revenue Cycle Management and consists of four stages, namely, Identifying, Managing, Monitoring and Preventing claim denials.

Medical professionals submit millions of claims every day to payors. Most claims are reimbursed fully by payors. As per the AMA reports, claims denied on the first submission amount to 1.38% to 5.07% of the total claims. Even the best-performing practices see a denial rate of 5%. Denied claims represent delayed or lost revenue to a practice. (more…)

Want to Run RCM Operations Efficiently? Check out these Best Practices

Aspects of revenue cycle management

What is Revenue Cycle Management?

Healthcare professionals train for years to treat patients and save lives while learning next to nothing about the business side of practices. Providers need to develop successful practice management processes to stay financially healthy. A medical facility’s entire financial process is termed Healthcare Revenue Cycle Management (RCM) and it covers management and collection of revenue from healthcare service to patients.

The healthcare revenue cycle starts when a patient makes his/her appointment to seek medical services from a healthcare provider. The process ends when claims are reimbursed and patient payments have been collected.  (more…)

Denial Management: 5 Effective Methods to Shrink Denials

Statistics for the Denial Management team

Denial Management is essential to a practice

Claim denials may be nothing unusual in healthcare, but the amount denied actually adds up to a substantial sum in the long run and is a loss of revenue for the practice. Studies have shown that many practices do not appeal to denial as they consider the denial management process expensive compared to the amount they will receive from payors.

This erroneous thinking results in leaving money on the table as statistics show that I in 5 claims is denied. Denial management is, therefore, something that every practice should take seriously.

The quantum of claim denials in a facility can be brought down by following the 5 approaches listed below: (more…)