Insurance Denial Management

Insurance Denials and Appeals

Claims that have been rejected or denied are carefully reviewed and resolved as quickly as possible. We utilize a three level appeal approach and handle incorrect denials by calling the payers directly, appeal in writing with supporting documentation, and if necessary utilize the administrative appeals approach to submit higher level appeals.

1. In instances when a simple phone call can be made to the payer to discuss an improper denial, we call immediately. This is the fastest way to get a claim reprocessed or resolved. We also utilize the payer’s website to submit corrections for quicker response.

2. We will carefully review the denial and request supporting documentation from your office and submit a written appeal to the payer when claims have been denied incorrectly. Our appeals are then carefully tracked and escalated if necessary.

3. Claims that are still denied incorrectly after the appeal has submitted will either be handled directly with the local provider representative or we will escalate the appeal utilizing the payer’s administrative appeals process.

4. We will also verify that your reimbursements correspond to your negotiated fee schedules and appeal any underpayments as necessary.

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See what a difference Capture Billing can make for You.
For a Free consultation by a Medical Billing Professional call

(703) 327-1800
or fill out the contact form.

Charge Entry Simplify your charge entry. We provide accurate entry of office and hospital visits, surgical and diagnostic procedures, plus labs.	Claim Submission Claims are filed, scrubbed, and checked for accuracy via our clearinghouse, with timely payment/EOB posting.	1 Pont of Contact We’re the primary point of contact for patients during the billing cycle — statements, payment plans, and collections.
Accounts Receivable Cash flow worries will be long forgotten, thanks to our timely and systematic claims follow-up procedures.	Denial Management When claims are denied, our certified billers and coders find the missing puzzle pieces fast, and refile or appeal the denial.	Customized Reports Our reporting package contains monthly customized reports, offering a detailed picture of your practice’s financial health.

PLUS:

*ICD-10 transition * Mini Chart Audits * Chart Accuracy Review

* Fee Schedule Evaluation * Document Scanning and Archiving

Revenue can be lost nearly anywhere in the billing cycle. So, our list of services covers the entire spectrum – from patient registration to collections. Below is just a short listing of our comprehensive services.

Only need to outsource certain tasks? We’ll work with you to determine the best plan for your practice’s bottom line.

Capture Billing and Consulting, Inc. relieves the burden of insurance and patient billing once and for all. You and your staff will have more time to do what you love and do best – provide the quality care your patients deserve.

Our comprehensive services are designed to maximize your profit while minimizing your costs. Let us take the stress out of your billing cycle.

Request a free customized quote below or call our billing specialists now at 703-327-1800.