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Denial Management (AR Calling)

Denial management is a critical element to a healthy cash flow, and successful revenue cycle management. FTBS helps providers to get quickly and easily determine the cause(s) of denials, mitigate the risk of future denials, and get paid faster.

With our effective denial management, the majority of denials can be prevented and revenue recovered.

For effective denial management, we translate the data into information we desperately need for effectively tracking and managing claim denials and make informed decisions based on a comprehensive denial management report.

When the provider is not contracted by the patient’s insurance then the provider is out of network. When patient receiving services from of network provider, the claim will be denied. When a claim is denied as the provider is out of network, we need to contact insurance to know whether the patient has out-of-network benefits. We collect claim number & denial date. Also, verify whether the patient is responsible for payment or not. The first follow-up would be sending a first-level appeal along with medical records, requesting the payor to reconsider the claim for payment. now if the appeal is upheld and denial maintained we will bill the patient if is the patient’s responsibility. Or Adjust the claim if the patient is not responsible for payment.

Falconre Technohealth Business Solutions denial management system categorizes denials, assigns work queues, creates follow-up lists, lets users track the progress of denials followed up on, and bubbles up denial patterns. So, get yourself an expert health care managing team from us and stop worrying over your workloads. 

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