Turning Denials Into Dollars
Are you tired of dealing with the frustration and financial loss caused by claim denials? Let us help you turn rejected claims into revenue with our proven denial management solutions.
Denial Management is one of the most important processes that can make or break the smooth functioning of a practice’s revenue cycle. There are two financial aspects to a denied claim - first is the “lost” revenue due to the improper prior authorization or the lack thereof and the second is the cost associated with reworking a denied claim, which entails a lengthy appeals process. Recent studies indicate that physicians spend anywhere from $30 to $100 or upward to rework a claim - costing the practice $14,400 (lowest estimate) annually based on 40 denied claims per month, not including the preliminary cost of submitting a claim.
The prevention of denials is always better than having to rework them - but this is easier said than done for most practices due to limitations in staff, time, and resources. Which is why we offer end-to-end denial management solutions to help maximize your revenue and minimize your administrative burdens.
At Bristol Healthcare, our proven process begins with a thorough analysis of low-pays, no-pays, and current denial trends and patterns to identify root causes. Our AR team works in close consultation with our coders to formulate and deploy specialty-specific guidelines that effectively resolve coding-related denials. We also assist your team with implementing strategies and SOPs designed to prevent any denials that may arise in the future to help shrink your AR days and maximize collections.
A Robust Denial Management Process
Bristol Healthcare’s denials management strategy follow tracking, categorizing and analyzing principles. Here is an outline of the typical steps involved in our denial management process:
- Track: The first step is to analyze the types of denials and review the explanation of benefits received from all payers. We also track all partial payments and non-payments and list them based on numbers and claim value.
- Categorize: We categorize denials by type and assign a denial code to them. Our categorization determines and lists down common denials.
- Analyze: Our experts conduct root cause analysis to identify patterns for each denial category and resolve them immediately. This involves reviewing claim data and reports, communicating with staff involved in the claims process, and reviewing payer policies and guidelines.
- Rectify: Once the root causes of denials are identified, we implement the required amendments. This involves updating policies and procedures, revising coding practices, and improving documentation practices to avoid and eliminate these denials in the future.
- Rework and Resubmit: Next we resubmit the denied claims with all the necessary corrections and documentation. During this phase, our AR team exercises extreme attention to detail to ensure that all required information is included and submitted accurately.
- Follow-up: After resubmitting claims, we routinely get in touch with the payers to ensure that they are being processed correctly and continuously update you on the status of the claim. Learn how our proprietary software - BristolBot™ assists you with real-time claim status checking and eligibility verification.
- Appeals: In the rare case of a claim being denied again, we submit additional information or evidence to support the claim, and communicate with the payer to advocate for the claim.
- Reports: Our team of specialists continuously monitor and generate periodic reports on the current status of denial rates, resubmissions and appeals. We also develop reports on the current trends to help identify opportunities and avenues for improvement.
Why Partner With Bristol Healthcare Services
Our comprehensive denial management services cover everything from claim tracking, analyzing, and follow-ups to appeals management and reporting. We work closely as an extension of your back office ensuring seamless integration with your existing systems and workflows, and provide ongoing training and support to ensure continued success.
- Affordable and flexible pricing plans.
- Increase collections by up to 30%.
- 95% Average collection ratio.
- Reduce outstanding AR days.
- Shrink rejections and denial rates.
- Get paid 2x faster.
- Improve operational efficiency.
- Certified professionals with multi-specialty expertise.
Schedule a Free Consultation Today
Partner with an expert who can handle all aspects of your practice's administrative and financial aspects - so you can focus on providing quality patient care. Get in touch with us to learn more about how our denial management solutions can help turn denials into revenue for your practice.Connect
Our team of experts are well versed and experienced with most of the popular software used by clients today.
What Our Clients Say
Together with our clients, BHS experts partner to achieve desired outcomes
and push the boundaries of what's possible.
“Jay – Great. I really appreciate your in-depth analysis on our outstanding. Your AR recovery process has been excellent.”
“We greatly appreciate the conscientious nature of your team. Their concern for quality is clear in the work that they perform.”
“Your attention to detail is excellent. Thanks for catching my staff’s error. I just love talking to Ray about process improvements.”
“Jay! Thanks to you and your team for formulating a winning team! I am proud to be aligned with you guys!”
“Our partnership with Bristol proved to be a game-changer. Their expertise in revenue cycle management and their commitment to delivering excellent service has truly transformed our practice's financial outlook.”
“If it wasn’t for your verification team, I would’ve never known I needed authorization for this surgical procedure. They have consistently sent verified reports on time, every day.”
“I highly recommend Bristol to any healthcare provider seeking a reliable and efficient medical billing partner. Their commitment to excellence, attention to detail, and dedication to maximizing revenue has been instrumental in helping our practice thrive financially.”
“Do you guys ever sleep? Thank you for answering all my questions immediately. I can’t imagine what I will do without your team.”
“I thank your coders for clearing our four months backlog within two weeks. I appreciate all your recommendations, it surely helps to improve our documentation.”
“Partnering with Bristol has been one of the best decisions I've made for my clinic, and I am grateful for their invaluable support."
“You have consistently provided accurate billing entries for us. I thank the entire team for a job well done."
“Your follow-up methodology seems to be working. Our collections have been increasing month on month. Great job! Stay on it.”
“I wanted to pass on our appreciation for the work the Bristol team is doing on the new BristolByte™ Quick Save feature. I am quite impressed by the speed with which the team is making design changes and implementing a process that will surely save us time. We appreciate it!”
“Their team took the time to understand our practice’s unique needs and workflows to implement a personalized billing process that ensured improved reimbursement rates. We’ve now eliminated duplicate data entry, minimized errors, and saved our staff valuable time.“
“With their expertise in managing our billing processes, we have been able to focus on what truly matters – delivering outstanding orthopedic care to our patients.”