Denial Management Services

'No' is something that we least expect when we are actually expecting a certainty, and when you get it for a claimable medical bill the pain is even more and frustrating. Fixing denials is a crucial part of processing medical bills and hitting the lowest medical denials is certainly a credible position to be in, and this is exactly where O2I's denial management services for medical billing pitch in.

Key Reasons for Denials

There are many issues that can arise leading to the denials in enrollment and credentialing. O2I has a separate physician enrollment and credentialing service which can effectively take care of physicians' denial management. Some of the main reasons for denials in medical billing are -

  • Incorrect patient information: This could be as simple as a misspelled name to grave differences like wrong information passed on by the patient
  • Invalid medical code: This is a major reason for denials, often codes are wrongly entered leading to a mismatch between codes and medication used
  • Documentation: Lack of documentation support or counter-acting documents
  • Clubbed or non-covered ailments: This is why it is important to talk to the patient's insurer before conducting the treatment, so that you and the patient has a clear idea of the type of claims receivable
  • Pre-authorization or pre-certification cases

O2I's Medical Billing Management Services to handle Denials

Identifying Key Reasons

Apart from the above mentioned reasons, O2I looks for and understands the frequent and hidden reasons behind constant denials and tries to draw the patterns and reasons which may be specific to your hospital or practice. This may need a complete examination of your billing procedures and management. Once this is done, we know exactly where we should look and start fixing, for faster reduction in denials and effective claims management.

Specialized Resources for Denial Management

Denial management in medical billing is crucial, so there must and should be specialists handling denials, as normal billing experts may not look at the whole process keeping the claims in perspective. Once a claim is denied there is a long and time-consuming process of following-up and re-submitting as per the prescribed norms, which makes it a diligent job. Therefore, O2I has employed specialized and experienced resources to handle denial management.

Read our article which lists the top 8 denial management best practices for hospitals.

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O2I Understands Various Insurer's Norms and Specific Procedures

This is the key, where the two ends meet, and this is also where O2I specializes in. Apart from claims denial management, it is our knowledge of working with many insurance companies that makes us adept at their standard and unique procedures. This makes the process easier as the entire billing preparation and other claims documents are prepared as per the insurer's norms. This not only helps avoid denials but also leads to faster payments.

Read our article on reasons and tips to improve healthcare claims denial management and learn how you can implement the same for your practice.

Outsource Denial Management to O2I

With streamlined medical billing process and vast experience in denial management services, medical claims recovery, and healthcare billing management, O2I can become the perfect service provider for you. O2I clearly brings down your claim denials by considerable margins. Outsource your health claim and billing management to us and focus on your practice.

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Denial Management Services FAQs

  • What is Denial Management?

    Denial management is the management of denials and involves gathering data on why claims are getting denied and learning how to avoid denials going forward.

  • What are the types of denials?

    There are many reasons for denials, including a claim having missing information, the presence of duplicate claims, non-coverage of a procedure, and expiry of the filing period.