Denial Management

Significance of denial analysis and denial resolutions

Claim denial analysis

Our committed team excels in performing comprehensive claim denial investigations, ensuring a meticulous process from the analysis of rejected claims to resolution. Experience the ease of resolving contradictions with our dedicated services, offering a transformative solution that enhances your financial workflow's efficiency and accuracy. Streamline your revenue cycle management through RND Softech's specialized denial analysis services. Trust us to handle the intricacies of billing denial reasons, providing comprehensive support in appealing denied claims. Whether you're managing healthcare denials or working in another industry, our modified denial analysis solutions seamlessly integrate into your overall revenue cycle management strategy. Choose RND Softech for an expert denial analysis experience, contributing to a challenging and streamlined revenue cycle for your business.

Claim denials resolution

Whether you're managing healthcare denials or working in other industries, our customized solutions for denial resolution seamlessly integrate into your overall revenue cycle management (RCM) strategy. Optimize your revenue cycle with RND Softech's dedicated services for claim denial resolution. Our dedicated medical billing team excels in navigating the complexities of denial reversal, ensuring a careful claims appeal process. Trust us to handle denial coding precisely, providing comprehensive support in appealing denied claims. Experience the ease of resolving contradictions with our dedicated services, offering a transformative solution that enhances your financial workflow's efficiency and accuracy. Choose us for an expert claim denials resolution experience, contributing to your business's robust and streamlined healthcare revenue cycle.

What are the common causes of claim denials?

Incomplete or inaccurate documentation

Inadequate documentation, missing information, or inaccuracies in Protected Health Information (PHI) records can lead to claim denials. Comprehensive and accurate documentation is essential for successful claims processing.
Coding errors

Incorrect medical coding, whether for procedures or diagnoses, is a frequent cause of denials. Payers may reject claims if the codes submitted do not align with the services provided.
Authorization and eligibility issues

Please obtain proper authorization or confirm patient eligibility before providing services to avoid claim denial. Healthcare providers must verify insurance coverage and obtain necessary approvals.
Timeliness of claims submission

Please submit claims within stipulated timeframes to avoid denial. Adhering to timely submission guidelines is imperative for preventing unnecessary rejections.
Lack of follow-up

Ineffective follow-up on denied claims contributes to revenue loss. Timely and persistent communication with payers is vital to resolve issues and secure reimbursement.

Strategies for prevention and effective denial management

Invest in training and education

We ensure that staff members at RND Softech involved in coding, billing, and documentation receive regular training to stay updated on industry changes and best practices.
Conducting regular audits

We perform routine audits of coding and billing processes to identify and rectify potential issues before claims are submitted. This proactive approach can significantly reduce the risk of claim denials.
Enhancing communications

Our open communication channels with payers to address issues promptly. Strong relationships with payers can lead to smoother claims processing and quicker dispute resolution.
Streamlined authorization processes

We implement efficient authorization workflows to obtain all necessary approvals before providing services. This can prevent denials related to authorization issues. At RND Softech, our Denial Management solution is crafted with precision to streamline and optimize the healthcare revenue cycle. Leveraging cutting-edge technology, we empower providers to identify, address, and mitigate claim denials swiftly, ensuring a seamless and efficient reimbursement process.

Try with RND Softech's 30day free trial to enhance your financial health by mastering Denial Management!

Frequently asked questions

The business world is being flattened by economics, technology, demographics and regulations. To win in this flattening world, companies must transform their way of working to seek and convert new opportunities wherever those opportunities may be. This means acquiring the ability to disaggregate your operations, people and resources across time zones, geographies, cultures and sourcing and delivering.

Why should I outsource to RND Softech?

By outsourcing to RND Softech, you will experience an immediate reduction of up to 60% in your manpower costs. We provide staff to take care of your front end and backend operations. This will enable you to focus on growing your business without having to worry about increasing operational costs, employee attrition, etc.
What are the services you offer?

We offer entire Revenue Cycle Management - a few of them being, data entry, insurance verification, authorization, Doctor's office followup, intake, order processing, billing, denial management, payment posting, inbound and outbound patient calling, 24 x 7 customer support, scheduling processes etc.
Do you have experience of working in the healthcare industry?

Yes, we have more than 22 years of experience working in the US healthcare industry. We have been providing medical transcription services to hospitals across the United States since 1999 and DME/Home care back office services since 2012.
What is your onboarding period for a new employee/customer?

Anywhere between 1 to 14 days.
What would be the FTE's working hours?

The FTE would work the US working hours, in the time zone of your choice.
Is the contract obligatory? Is there a minimum or maximum contract period?

Yes, but it is a no-obligations contract and is non-binding and there is no minimum contract period. The contract simply states that the two companies are entering into a partnership for the providing and receiving services. You can terminate the contract if you are not satisfied with the services. A notice period of 1 month is appreciated but not mandatory.
Are you HIPAA compliant?

Yes, we are certified for HIPAA and Information Security Management Systems.
Is there any contract to be signed before getting started?

No, the contract is not obligatory and there is no minimum contract period. The contract simply states that the two companies are entering into a partnership for the providing and receiving services. You can terminate the contract if you are not satisfied with the services. A notice period of 1 month is appreciated but not mandatory.
Do you follow FTE based billing or percentage of revenue generated billing?

We follow an FTE-based billing. One FTE (full time employee) works 8 hours a day, 5 days a week - a total of 40 hours a week.
How will I be billed?

You will be sent an invoice each month mentioning the number of FTEs agreed upon and the services provided.
How can I make payments?

You can make payments through Paypal using your credit card or make a wire transfer.
Are the FTEs your own employees or do you subcontract to other smaller companies?

All our FTEs are employees of RND Softech and are dedicated to each client, the agent will not be shared with other clients
Where are you located?

We are located in Southern part of India.
Do you follow US holidays or local?

Yes, We follow US holidays.
Are You Certified?

Yes we are one ISO 9001, ISO 27001, HIPPA and SOC2 Certificates.