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Accountable Care Management
Spend and Clinical Resource Management
Advisory Solutions
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| Denial Management |
| Identify and account for all payer denials and target problem areas that affect the bottom line to assure collection of all receivables due from payers. |
- Automates and accelerates the identification and resolution of claim and service-level denials
- Permits analysis of payer adjustment codes on remittance advices and processing of denials according to client-driven parameters
- Identifies automatically denial reason and routes claims to individuals who can research, correct and re-file claims
- Integrates seamlessly with existing patient accounting systems and assures collection of all receivables due from payers
- Generates reports for measuring and managing staff or department performance:
- Determines patterns of common errors from upstream departments
- Identifies recurring problems with master files, such as Insurance and chargemaster files
- Quantifies upstream revenue opportunities
- Reports on active workload management
- Reviews productivity and financial analysis of incoming denials
- Supplies timely information about payer reimbursements for appeals and rebilling as well as online denial reports in multiple formats, so managers can perform root cause analysis on denied claims:
- Percentage of claims denied
- Most common types of denials
- Payers denied most frequently
- Net effect of denials on cash flow
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Improve your Operating Margins
MedAssets improves and sustains operating margins by 1.5% to 5%.
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