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Denial Management
Common Reasons for Denials and
Delayed Account Resolution
Sanjay Patil is a Healthcare IT consultant with
top tier consulting experience in successfully
delivering large scale custom development projects,
application integration, content management,
portal solutions and implementation of health care
business solutions. He has been actively involved
in Meaningful Use and is passionate about creating
IT solutions for providers w.r.t different regulatory
programs. He has worked in delivering solutions
across all product lines such as EMR, EHR ,Care
Coordination, Patient Engagement.
Background
Reasons for Denials
Technology Solutions
Conclusion
About Us
3
3
7
9
10
Contents
All rights reserved © 2019 9
In
Conclusion
While claim denials are a chief source of aggravation
for billing department, and it is also the jugular of your
organization’s cash flow.
By proactively striving to identify, manage and prevent denials using
automation and business intelligence, there can be drastic change
in educating employees, streamline work flows, improve internal
processes, and get paid what the healthcare organization deserves.
YTD & MTD HCPCS, Revenue Code, DRG by payor, procedure and
provider.
YTD & MTD Actual Reimbursement vs. Expected reimbursement by
payor, procedure, provider
YTD & MTD Payment reports by time duration – average time from
claim submission to payment by payor, procedure and provider.
YTD & MTD Appeal success – number of denials, number of appeals
submitted, number of appeals approved by payor, procedure and
provider.
Speak With the Experts
Concerned about claim denials? Get in touch with us
today for high end, customized healthcare solutions.
We listen, we understand and we deliver.
We have been around for a while now and have been making our
mark in the Healthcare industry. We have been steadily moving into
various areas of US Healthcare, starting off from Meaningful Use Stage
2. With time we have traversed the journey from the clinical space to
financial aspects of healthcare. Kind words from our clients and their
continued belief in our capabilities to deliver have kept us steadfast
on the path of growth.
Contact Us
555 US Highway 1 South, Suite 170, Iselin, NJ 08830, USA
732-602-2560 X 200	 www.nalashaahealth.com
About Us

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Denial Management:- The common Reasons for Health Insurance Denials

  • 1. Denial Management Common Reasons for Denials and Delayed Account Resolution Sanjay Patil is a Healthcare IT consultant with top tier consulting experience in successfully delivering large scale custom development projects, application integration, content management, portal solutions and implementation of health care business solutions. He has been actively involved in Meaningful Use and is passionate about creating IT solutions for providers w.r.t different regulatory programs. He has worked in delivering solutions across all product lines such as EMR, EHR ,Care Coordination, Patient Engagement.
  • 2. Background Reasons for Denials Technology Solutions Conclusion About Us 3 3 7 9 10 Contents
  • 3. All rights reserved © 2019 9 In Conclusion While claim denials are a chief source of aggravation for billing department, and it is also the jugular of your organization’s cash flow. By proactively striving to identify, manage and prevent denials using automation and business intelligence, there can be drastic change in educating employees, streamline work flows, improve internal processes, and get paid what the healthcare organization deserves. YTD & MTD HCPCS, Revenue Code, DRG by payor, procedure and provider. YTD & MTD Actual Reimbursement vs. Expected reimbursement by payor, procedure, provider YTD & MTD Payment reports by time duration – average time from claim submission to payment by payor, procedure and provider. YTD & MTD Appeal success – number of denials, number of appeals submitted, number of appeals approved by payor, procedure and provider. Speak With the Experts Concerned about claim denials? Get in touch with us today for high end, customized healthcare solutions.
  • 4. We listen, we understand and we deliver. We have been around for a while now and have been making our mark in the Healthcare industry. We have been steadily moving into various areas of US Healthcare, starting off from Meaningful Use Stage 2. With time we have traversed the journey from the clinical space to financial aspects of healthcare. Kind words from our clients and their continued belief in our capabilities to deliver have kept us steadfast on the path of growth. Contact Us 555 US Highway 1 South, Suite 170, Iselin, NJ 08830, USA 732-602-2560 X 200 www.nalashaahealth.com About Us