Denial Management Services

Leverage Our Data-Led, Analytical Approach For Effective Mitigation Of Denials

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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.

How we work

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.
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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.
Let’s Connect

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.


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