Getting a Jump Start on Denial Resolution as Early as One Day Post-Billing
Ovation Revenue Cycle Services’ Claim Status Inquiry gives revenue cycle managers a jump start on resolving denials and other obstacles that cause payment delays. Delayed payment may result from denied services, lost claims, and pended claims while the payer requests additional supporting documentation.
Delays can be minimized by resolving issues early. The earlier staff members are aware that the claim has been assigned a denied/no-pay status and is able to identify exactly what is missing, the faster the claim can be reprocessed to the payer. By avoiding and/or minimizing delays between billing and payment, businesses can increase cash flow and productivity.
Ovation Revenue Cycle Services’ Claim Status Inquiry uses payer portal “screen scraping” to identify claims with a denied/no-pay status and present the information in an easy to understand format to the staff for rapid resolution as early as one day post-billing. Claims scheduled to pay are not queued to the staff workflow which enables the staff to focus only on issues that need to be addressed.
This exception-based workflow tool enables the staff to focus 100% of their time and energy on resolving payment delay issues. A typical scenario involves waiting 30 to 45 days post-billing to receive the payer remittance to learn that a claim is denied, documents are missing, or additional information is requested and struggling to understand the minimal EDI information that is not detailed enough for staff to understand the real issue that needs to be corrected. Ovation Revenue Cycle Services’ Claim Status Inquiry takes this ambiguity out of the no-pay status and enables the claim to be worked as early as one day post-billing. The workflow technology provides specifics on line-item denials which are not clear from high-level ANSI Codes. Reporting trending and analysis capabilities enables the managers to implement process improvement initiatives to reduce process related denials and other workflow issues that delay payment.
In addition to providing easy-to-understand information to help the staff resolve the issues, line-item denials may be prioritized according to the rules established by the manager. This customization enables the manager to fully control their staff assignments and direct their staff to the claims with greatest impact potential. One large health system reduced their denials from 6% to less than 1% while realizing a 51% increase in net revenue per FTE after implementing Ovation Revenue Cycle Services’ Claim Status Inquiry.
To learn more about Ovation Revenue Cycle Services’ Comprehensive Coding Services, visit www.ovationrcs.com.
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