PayerLogicSM Denial Management Solutions
Rapid growth in managed care has sparked a staggering increase in denials, with payers denying 15-20% of provider charges. Add to this almost 45 million more people who will be eligible for some kind of coverage under the Patient Protection and Affordable Care Act, and the need for a denial management solution has never been greater. Plus, ICD-10 implementation will entail a 700% increase in procedure and diagnostic codes. So, no matter how experienced your staff is, workloads are likely to increase significantly, require added labor intensity, and necessitate process changes…thus increasing probability of errors and resultant denials.
PayerLogicSM Denial Solutions helps you turn denials into revenue. Our approach is two-fold: our experts not only analyze and overturn clinical, technical and other denials but also work with you to identify process improvements to help prevent future charges from turning into denials.
Our aggressive approach yields reimbursement on an average 90% of referred viable claims, increasing your cash flow and letting payers know you are unwilling to accept denials as a routine cost.
Leveraging Human Arc’s expertise and technologies eliminates your investment in expensive software or other in-house capabilities.
Improve Denials Management Processes.
We work with you to identify and implement best practices that facilitate collaboration across your organization, establish common data sources, and leverage your growing abilities to manage denials and minimize their impact.
The Human Arc Edge
Human Arc’s experience and industry knowledge goes unrivaled. Our specialists stay up to date on standards in procedures and coding to ensure that no matter the denials issue—whether common like Medicare ADRs or state-specific like Medicaid inpatient admission pre-cert requirements—we are prepared to tackle it.
Information Flexibility and Speed.
You shouldn’t have to wait for the information you need. We provide you with precisely targeted data, drilled down to exactly what you need to know about your denials—and it’s all available to you online 24/7/365.
Focus on the Real Goal.
Our data and denial management consulting services help you grow your abilities to reduce denials to their minimum rather than simply bandaging the problem by focusing only on overturning denials.
Security and Compliance.
You can rest assured your patients’ information is kept confidential and remains fully protected with Human Arc’s experts who are 100% trained on HITECH/HIPAA.
PayerLogic Denial Solutions information
Denials Management - In-source, Outsource or Both?
A Human Arc white paper by Holly Pelaia, Vice President of Operationsdownload the white paper
Overturning 73% of All Denials Referred by the Client!
Appealing Denials for Extra $100,000/Month
$387,000 Reimbursement on First Appeal
Winning 86% of Appeals