Denial Management V2.1 

Get your Ducks in a row!   Know what is happening with your denials then take action.

Remittance Advices, and even paper RA’s (input via Premier's Manual Payment Entry Product) provide a tremendous amount of information that can be utilized to identify and track claim status.  This information assists in overturning denials.  Information gathered from remittance advices is put to use in our powerful new Denial Management module.  Denial Management produces indispensable work-lists and reports that allow you to take greater advantage of this data than ever before possible.  With Denial Management, you can easily identify denied claims; review those claims and associated remittance advices.  By accessing payer instructions, and consulting your own procedures to understand and take appropriate steps to more efficiently complete your billing and collections process.

 

Features:

• Denials are sent to work lists.  Work lists can be assigned to Reps or Teams based on Remittance Type, Reason Groups, Carrier, and/or by patient last name.
• 3 levels of user security are available, Employee, Supervisor, Manager.
• Action lists are functions used to process denials: Edit, Delete, Adjust, Overturn, Close Carrier, Appeal, Complete.   Hospital specific Appeal Letter Templates can be used when working the denial and be picked from a list then automatically generated.
• Audit Logging: All changes or re-assignments are logged with comments that include the date, time, and the user that made the change.
• Complete option is used when there are no additional actions that can be taken to overturn the denial.
• Bill next carrier option flags the account for the MS4 system to bill the next carrier.
• Summary and line level detail can be displayed if available from the payer.
• Options: Account notes, Hold Data Mailer, un-assigned work list, Review date control.
• Reports.   Various reports can be generated such as reason code, trend analysis, Denied Recovery Analysis, Rep Productivity Report.  Other reports can be created per your request.

ERA enhancements that increase the capabilities of Denial Management:

•  Reason Code maintenance with option to do an 841 import of code files from Washington Publishing.
• Common code functionality allows carrier specific codes can be mapped to a hospital defined common code for ease of reporting and grouping across carriers.

For a little more detail click here.

We’d love to show you much more and how you can use Premier Software's powerful Denial Management tool to take action and take control of your denied claims.  To schedule a demo or request more information email us at info@premsoft.com or call us at 1-801-299-8772 x118 or x128.