Can you afford uncontrolled denials?

At an average hospital, approximately 4-6% of gross revenue is never recovered due to denials, causing millions of dollars in lost revenue. Source: Healthcare Advisory Board, HFMA.

Take the initiative to begin managing the financial impact of your denials.

Denials Guru is a denial management solution that minimizes revenue loss, enabling hospitals to reduce A/R, increase revenue, and achieve denial rates of less than 1%.

Reporting Module—a system that analyzes your hospital’s total current rejection patterns and identifies problem areas within your revenue cycle. Management can move information into an Excel^® spreadsheet with one click and view reports ranging from hospital comparisons for large providers to drill-down patient-level reports for any hospital. After corrective actions are taken, their success can be measured with key trending reports.

• Root-Cause Analysis—tools within the reporting module that allow you to automatically identify the specific causes of denials in your revenue cycle. Highly detailed and configurable, these analyses improve performance and decision-making.

Workflow Module—an automatic tracking, trending, and reporting system that originates from your 835 remits. This comprehensive management tool facilitates the cross-department communication needed to resolve payment rejections quickly and efficiently. At any point in the remediation process, management reports allow you to understand the status of a denial. Denials Guru assigns denials to the appropriate users and maintains a workflow history of every action taken. Guru also provides the necessary tools to manage and assign denials as they are received, and to configure workflow tables for your staff.

• Knowledgebase Development—system within the workflow module that defines denial reasons, finds the best practice methods, and uses the payors’ denial codes to learn which denials can be overturned, and how to recover them.

A|Rmed® Feedback Loop—when used in conjunction with Denials Guru, A|Rmed creates a proactive, intelligent link between your 835 remittances and your 837 claims submissions. Denials Guru can automatically feed your 835 remittance information back into A|Rmed, which in turn allows A|Rmed to “learn” from your denials. Together, they can generate proactive commercial edits that effectively reverse-engineer your payors’ “black-box” edits.

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